Repair of partial atrioventricular septal defect in children less than five years of age: late results.

BACKGROUND: Presently, surgical correction of partial atrioventricular septal defects is an extremely viable option giving good results. An aggressive approach toward operating on these patients at an early age may be warranted given the otherwise unfavorable natural history.

METHODS: A retrospective study was done in 38 consecutive patients from 3 to 58 months of age, who underwent correction between 1981 and 1997. Preoperatively, moderate to severe mitral regurgitation was present in 45% of the patients. Congestive cardiac failure was noted in 41% of the cases. Closure of the left atrioventricular valve cleft was performed in 92% of the cases. A need for mitral annuloplasty was felt in 28% of the cases. Majority of the ostium primum defects in our series were closed by a pericardial patch.

RESULTS: The early, 30 day mortality was 7.9%. A significantly low incidence of late mitral regurgitation (0.9%) was noted on a follow-up extending up to 14 years. There was only one reoperation during late follow-up. On their last follow-up, 87% of the patients are asymptomatic.

CONCLUSION: An aggressive approach toward operating at an early age on children with this malformation is safe, effective, and yields excellent long term results.