Population-Based Perspective of Long-Term Outcomes After Surgical Repair of Partial Atrioventricular Septal Defect

Karl F. Welke, Cynthia Morris, Emily King, Christopher Komanapalli, Mark Reller, Ross M. Ungerleider

Research output: Contribution to journalArticle

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Abstract

Background: This investigation was designed to determine long-term survival, reoperation rates, and functional status after surgical repair of partial atrioventricular septal defect (PAVSD). Methods: This population-based cohort study with cumulative, prospective follow-up by questionnaire and medical record review included all patients aged younger than 19 years old in the state of Oregon who underwent surgical repair of a PAVSD from 1958 to 2000. The incidence of early death, late death, and reoperation for left atrioventricular valve pathology were determined. Patient-reported health status as measured by the Medical Outcomes Study Short Form 12 (SF-12) was obtained for patients without Down syndrome when they were aged older than 15 years. Results: Repair of PAVSD was done in 133 patients. Median follow-up was 8.7 years for a total of 1541 person-years. Mean age at the initial operation was 5.2 ± 5.1 years (median, 3.4 years). Mean weight was 19.2 ± 16.0 kg (median, 13.2 kg). Survival was 95% at 30 days, 87% at 10 years, and 78% at 30 years. Reoperation for left atrioventricular valve pathology was done 15 patients (11.3%). Lower weight, absence of Down syndrome, and lack of mitral valve cleft repair were significantly associated with undergoing reoperation. Patient-reported health status was obtained in 35 patients. For this group, the mean SF-12 summary scores for the physical component (52.8 ± 9.0) and the mean mental component (50.3 ± 11.0) were not significantly different from age-adjusted norms. Conclusions: The survival rate for this simple cardiac defect is lower than the general population. In addition, the reoperation rate is significant. Despite this, in general, patients without Down syndrome can expect normal functional health status.

Original languageEnglish (US)
Pages (from-to)624-629
Number of pages6
JournalAnnals of Thoracic Surgery
Volume84
Issue number2
DOIs
StatePublished - Aug 2007

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Reoperation
Population
Down Syndrome
Health Status
Survival Rate
Pathology
Weights and Measures
Partial atrioventricular canal
Mitral Valve
Medical Records
Cohort Studies
Outcome Assessment (Health Care)
Survival
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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Population-Based Perspective of Long-Term Outcomes After Surgical Repair of Partial Atrioventricular Septal Defect. / Welke, Karl F.; Morris, Cynthia; King, Emily; Komanapalli, Christopher; Reller, Mark; Ungerleider, Ross M.

In: Annals of Thoracic Surgery, Vol. 84, No. 2, 08.2007, p. 624-629.

Research output: Contribution to journalArticle

Welke, Karl F. ; Morris, Cynthia ; King, Emily ; Komanapalli, Christopher ; Reller, Mark ; Ungerleider, Ross M. / Population-Based Perspective of Long-Term Outcomes After Surgical Repair of Partial Atrioventricular Septal Defect. In: Annals of Thoracic Surgery. 2007 ; Vol. 84, No. 2. pp. 624-629.
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abstract = "Background: This investigation was designed to determine long-term survival, reoperation rates, and functional status after surgical repair of partial atrioventricular septal defect (PAVSD). Methods: This population-based cohort study with cumulative, prospective follow-up by questionnaire and medical record review included all patients aged younger than 19 years old in the state of Oregon who underwent surgical repair of a PAVSD from 1958 to 2000. The incidence of early death, late death, and reoperation for left atrioventricular valve pathology were determined. Patient-reported health status as measured by the Medical Outcomes Study Short Form 12 (SF-12) was obtained for patients without Down syndrome when they were aged older than 15 years. Results: Repair of PAVSD was done in 133 patients. Median follow-up was 8.7 years for a total of 1541 person-years. Mean age at the initial operation was 5.2 ± 5.1 years (median, 3.4 years). Mean weight was 19.2 ± 16.0 kg (median, 13.2 kg). Survival was 95{\%} at 30 days, 87{\%} at 10 years, and 78{\%} at 30 years. Reoperation for left atrioventricular valve pathology was done 15 patients (11.3{\%}). Lower weight, absence of Down syndrome, and lack of mitral valve cleft repair were significantly associated with undergoing reoperation. Patient-reported health status was obtained in 35 patients. For this group, the mean SF-12 summary scores for the physical component (52.8 ± 9.0) and the mean mental component (50.3 ± 11.0) were not significantly different from age-adjusted norms. Conclusions: The survival rate for this simple cardiac defect is lower than the general population. In addition, the reoperation rate is significant. Despite this, in general, patients without Down syndrome can expect normal functional health status.",
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