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. 2015 Jul-Sep;30(3):304-10.
doi: 10.5935/1678-9741.20150036.

Factors associated with moderate or severe left atrioventricular valve regurgitation within 30 days of repair of complete atrioventricular septal defect

Marcelo Felipe Kozak  1 , Ana Carolina Leiroz Ferreira Botelho Maisano Kozak  1 , Carlos Henrique De Marchi  1 , Sirio Hassem Sobrinho Junior  2 , Ulisses Alexandre Croti  1 , Airton Camacho Moscardini  1
Affiliations

Factors associated with moderate or severe left atrioventricular valve regurgitation within 30 days of repair of complete atrioventricular septal defect

Marcelo Felipe Kozak et al. Rev Bras Cir Cardiovasc. 2015 Jul-Sep.

Abstract
in English, Portuguese

Introduction: Left atrioventricular valve regurgitation is the most concerning residual lesion after surgical correction of atrioventricular septal defects.

Objective: To determine factors associated with moderate or severe left atrioventricular valve regurgitation within 30 days of surgical repair of complete atrioventricular septal defect.

Methods: We assessed the results of 53 consecutive patients 3 years-old and younger presenting with complete atrioventricular septal defect that were operated on at our practice between 2002 and 2010. The following variables were considered: age, weight, absence of Down syndrome, grade of preoperative atrioventricular valve regurgitation, abnormalities on the left atrioventricular valve and the use of annuloplasty. Median age was 6.7 months; median weight was 5.3 Kg; 86.8% had Down syndrome. At the time of preoperative evaluation, there were 26 cases with moderate or severe left atrioventricular valve regurgitation (49.1%). Abnormalities on the left atrioventricular valve were found in 11.3%; annuloplasty was performed in 34% of the patients.

Results: At the time of postoperative evaluation, there were 21 cases with moderate or severe left atrioventricular valve regurgitation (39.6%). After performing a multivariate analysis, the only significant factor associated with moderate or severe left atrioventricular valve regurgitation was the absence of Down syndrome (P=0.03).

Conclusion: Absence of Down syndrome was associated with moderate or severe postoperative left atrioventricular valve regurgitation after surgical repair of complete atrioventricular septal defect at our practice.

Introdução: A insuficiência da valva atrioventricular esquerda é a lesão residual mais preocupante após o tratamento cirúrgico do defeito de septo atrioventricular.

Objetivo: Determinar fatores associados à insuficiência da valva atrioventricular esquerda de grau moderado ou importante nos primeiros 30 dias após correção de defeito de defeito de septo atrioventricular total.

Métodos: Avaliamos os resultados em 53 pacientes consecutivos menores de 3 anos com defeito de septo atrioventricular total, operados em nosso serviço entre 2002 e 2010. Avaliamos as seguintes variáveis: idade, peso, ausência de síndrome de Down, grau de insuficiência da valva atrioventricular esquerda antes da correção, anormalidades na valva atrioventricular e uso de anuloplastia. A mediana da idade foi de 6,7 meses e a do peso de 5,3 Kg; 86,8% tinham síndrome de Down. Antes da operação, 26 apresentavam insuficiência da valva atrioventricular esquerda pelo menos moderada (49,1%). Anormalidades na valva atroventricular foram encontradas em 11,3% dos casos; anuloplastia foi realizada em 34% dos pacientes.

Resultados: Após a correção, houve 21 casos com insuficiência moderada ou grave da valva atrioventricular esquerda (39,6%). Após realização de análise multivariada, o único fator associado com esses graus de insuficiência foi a ausência da síndrome de Down (P=0,03).

Conclusão: Ausência de síndrome de Down esteve associada com insuficiência moderada ou grave da valva atrioventricular esquerda após correção cirúrgica de defeito de septo atrioventricular total em nosso serviço.

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