Long-term outcomes following atrioventricular septal defect in adult patients.

OBJECTIVE

To assess the results after repair of atrioventricular septal defect (AVSD) in adult patients in our centre.

METHODS

We assessed 168 patients who received AVSD repair at a single institution from 2013 to 2023. Relevant data were obtained from medical and surgical records, and focused on the early and long-term results.

RESULTS

Median age at surgery was 36.4 (27.0-47.8) years. One hundred and forty-seven patients (87.5%) with partial AVSD, 15 patients (8.9%) with intermediate AVSD and six patients (3.6%) with complete AVSD. Left atrioventricular valve (LAVV) regurgitation was present in 160 patients; the LAVV clefts were closed completely in 155 patients (92.3%), of which 36 (21.4%) underwent mitral valve ring annuloplasty and 18 (10.7%) patients underwent additional implantation of an incomplete flexible band into the LAVV. There were two early deaths, with two deaths over a median follow-up of 36.0 (14.0-60.0) months. According to the follow-up outcomes, the heart measurement, pulmonary artery pressure and valve regurgitations recovered significantly. A total of 34 patients underwent 37 reoperations. The majority of subsequent reoperations were performed because of residual LAVV pathology (n = 6, 16.2%), and arrhythmias (n = 31, 91.2%). Competing risks analysis revealed that 10 years after the initial operation, 2.6% had died without reintervention, 23.3% had received reintervention and 74.7% were alive without reintervention.

CONCLUSIONS

AVSD in adult patients can be done safely with low early mortality and good long-term out-comes. While the reoperation rate is minimal, it is important to closely monitor the significant occurrence of arrhythmias.