Twenty-two patients of atrioventricular septal defect repair with prosthetic valve ring implantation: A retrospective cohort study in a single center_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YAO Zeyang ^1,2 , XIE Wen ^1,2 , CHEN Zewen ² , JI Erchao ^1,2 , XU Xiaowei ² , LIU Tao ³ , WEN Shusheng ² , XU Gang ² ,  ZHUANG Jian ^1,2

1. Department of Cardiovascular Surgery, School of Medicine, South China University of Technology, Guangzhou, 510080, P. R. China;
2. Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Institute of Cardiovascular Disease, Guangzhou, 510080, P. R. China;
3. Department of Biostatistics, Center for Statistical Sciences, School of Public Health, Brown University, Providence, 02912, USA;

Corresponding author：

ZHUANG Jian, Email: zhuangjian5413@163.com

Keywords：

Atrioventricular septal defect; valve regurgitation; prosthetic valve ring; retrospective study

DOI：

10.7507/1007-4848.202011027

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Objective To review the characteristics of patients who underwent atrioventricular septal defects (AVSD) repair with prosthetic valve ring implantation in our hospital, and to analyze the safety and effectiveness of this intervention.Methods The clinical data of all patients diagnosed with AVSD who received surgery repair and prosthetic valve ring implantation from January 1, 2018 to July 12, 2020 in Guangdong Provincial People's Hospital were collected and analyzed. There were 22 patients with 9 males and 13 females at a median age of 35.00 (14.10, 53.00) years. There were 9 (40.9%) patients with prosthetic half or full rings placed on the left atrioventricular valve and 18 (81.8%) patients with prosthetic half or full rings placed on the right atrioventricular valve. Results The median postoperative hospital stay was 7.00 (6.00, 8.80) d, and the postoperative mechanically assisted ventilation time was 11.00 (6.25, 19.00) h. There were 2 (9.1%) patients of moderate or higher postoperative atrioventricular valve regurgitation, 1 on the left and 1 on the right. There was one patient (4.5%) of the postoperative residual septal defect. There was no left ventricular inflow or outflow tract obstruction and no postoperative residual atrial septal defect during the follow-up of 152.00 (124.00, 1 030.00) d.Conclusion Implantation of a prosthetic ring is safe and effective in patients with AVSD, and the structural strength of the ring may be improved after the implantation. The physiological development of the AVSD annulus after prosthetic ring implantation and the results of long-term follow-up needs further attention.

Citation： YAO Zeyang, XIE Wen, CHEN Zewen, JI Erchao, XU Xiaowei, LIU Tao, WEN Shusheng, XU Gang, ZHUANG Jian. Twenty-two patients of atrioventricular septal defect repair with prosthetic valve ring implantation: A retrospective cohort study in a single center. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(10): 1362-1366. doi: 10.7507/1007-4848.202011027 Copy

1.	Jacobs JP, Burke RP, Quintessenza JA, et al. Congenital heart surgery nomenclature and database project: Atrioventricular canal defect. Ann Thorac Surg, 2000, 69(3): 36-43.
2.	Jacobs JP, Jacobs ML, Mavroudis C, et al. Atrioventricular septal defects: Lessons learned about patterns of practice and outcomes from the congenital heart surgery database of the society of thoracic surgeons. World J Pediatr Congenit Heart Surg, 2010, 1(1): 68-77.
3.	Hoohenkerk GJ, Bruggemans EF, Rijlaarsdam M, et al. More than 30 years' experience with surgical correction of atrioventricular septal defects. Ann Thorac Surg, 2010, 90(5): 1554-1561.
4.	Boening A, Scheewe J, Heine K, et al. Long-term results after surgical correction of atrioventricular septal defects. Eur J Cardiothorac Surg, 2002, 22(2): 167-173.
5.	Fong LS, Betts K, Bell D, et al. Complete atrioventricular septal defect repair in Australia: Results over 25 years. J Thorac Cardiovasc Surg, 2020, 159(3): 1014-1025.
6.	Tishler B, Gauvreau K, Colan SD, et al. Technical performance score predicts partial/transitional atrioventricular septal defect outcomes. Ann Thorac Surg, 2018, 105(5): 1461-1468.
7.	Piccoli GP, Ho SY, Wilkinson JL, et al. Left-sided obstructive lesions in atrioventricular septal defects: An anatomic study. J Thorac Cardiovasc Surg, 1982, 83(3): 453-460.
8.	Shiokawa Y, Becker AE. The left ventricular outflow tract in atrioventricular septal defect revisited: Surgical considerations regarding preservation of aortic valve integrity in the perspective of anatomic observations. J Thorac Cardiovasc Surg, 1997, 114(4): 586-593.
9.	Schleiger A, Miera O, Peters B, et al. Long-term results after surgical repair of atrioventricular septal defect. Interact Cardiovasc Thorac Surg, 2019, 28(5): 789-796.
10.	Kulkarni D, Jain K, Menander M, et al. Retrospective study to compare ring annuloplasty and suture annuloplasty in tricuspid valve diseases. IOSR-JDMS, 2016, 15(7): 42-44.
11.	Bhagwan J, Guha S, Gupta A, et al. A comparative analysis between ring annuloplasty and de vega annuloplasty in functional tricuspid regurgitation. Int Surg, 2018, 5(6): 2131-2136.
12.	Antunes MJ, Finucane K, Kumar AS, et al. Surgical management of rheumatic valvular heart disease. acute rheumatic fever and rheumatic heart disease. Amsterdam: Elsevier. 2020.147-170.
13.	Wetter J, Sinzobahamvya N, Blaschczok C, et al. Closure of the zone of apposition at correction of complete atrioventricular septal defect improves outcome. Eur J Cardiothorac Surg, 2000, 17(2): 146-153.
14.	Krawczyk-Ożóg A, Hołda MK, Sorysz D, et al. Morphologic variability of the mitral valve leaflets. J Thorac Cardiovasc Surg, 2017, 154(6): 1927-1935.
15.	Kanani M, Elliott M, Cook A, et al. Late incompetence of the left atrioventricular valve after repair of atrioventricular septal defects: The morphologic perspective. J Thorac Cardiovasc Surg, 2006, 132(3): 640-646.
16.	Moorjani N, Rana BS, Wells FC. Annular dilatation. In: Operative Mitral and Tricuspid Valve Surgery. Berlin: Springer, 2018.113-121.
17.	Yamauchi T, Taniguchi K, Kuki S, et al. Evaluation of the mitral valve leaflet morphology after mitral valve reconstruction with a concept "coaptation length index". J Card Surg, 2005, 20(5): 432-435.

1. Jacobs JP, Burke RP, Quintessenza JA, et al. Congenital heart surgery nomenclature and database project: Atrioventricular canal defect. Ann Thorac Surg, 2000, 69(3): 36-43.
2. Jacobs JP, Jacobs ML, Mavroudis C, et al. Atrioventricular septal defects: Lessons learned about patterns of practice and outcomes from the congenital heart surgery database of the society of thoracic surgeons. World J Pediatr Congenit Heart Surg, 2010, 1(1): 68-77.
3. Hoohenkerk GJ, Bruggemans EF, Rijlaarsdam M, et al. More than 30 years' experience with surgical correction of atrioventricular septal defects. Ann Thorac Surg, 2010, 90(5): 1554-1561.
4. Boening A, Scheewe J, Heine K, et al. Long-term results after surgical correction of atrioventricular septal defects. Eur J Cardiothorac Surg, 2002, 22(2): 167-173.
5. Fong LS, Betts K, Bell D, et al. Complete atrioventricular septal defect repair in Australia: Results over 25 years. J Thorac Cardiovasc Surg, 2020, 159(3): 1014-1025.
6. Tishler B, Gauvreau K, Colan SD, et al. Technical performance score predicts partial/transitional atrioventricular septal defect outcomes. Ann Thorac Surg, 2018, 105(5): 1461-1468.
7. Piccoli GP, Ho SY, Wilkinson JL, et al. Left-sided obstructive lesions in atrioventricular septal defects: An anatomic study. J Thorac Cardiovasc Surg, 1982, 83(3): 453-460.
8. Shiokawa Y, Becker AE. The left ventricular outflow tract in atrioventricular septal defect revisited: Surgical considerations regarding preservation of aortic valve integrity in the perspective of anatomic observations. J Thorac Cardiovasc Surg, 1997, 114(4): 586-593.
9. Schleiger A, Miera O, Peters B, et al. Long-term results after surgical repair of atrioventricular septal defect. Interact Cardiovasc Thorac Surg, 2019, 28(5): 789-796.
10. Kulkarni D, Jain K, Menander M, et al. Retrospective study to compare ring annuloplasty and suture annuloplasty in tricuspid valve diseases. IOSR-JDMS, 2016, 15(7): 42-44.
11. Bhagwan J, Guha S, Gupta A, et al. A comparative analysis between ring annuloplasty and de vega annuloplasty in functional tricuspid regurgitation. Int Surg, 2018, 5(6): 2131-2136.
12. Antunes MJ, Finucane K, Kumar AS, et al. Surgical management of rheumatic valvular heart disease. acute rheumatic fever and rheumatic heart disease. Amsterdam: Elsevier. 2020.147-170.
13. Wetter J, Sinzobahamvya N, Blaschczok C, et al. Closure of the zone of apposition at correction of complete atrioventricular septal defect improves outcome. Eur J Cardiothorac Surg, 2000, 17(2): 146-153.
14. Krawczyk-Ożóg A, Hołda MK, Sorysz D, et al. Morphologic variability of the mitral valve leaflets. J Thorac Cardiovasc Surg, 2017, 154(6): 1927-1935.
15. Kanani M, Elliott M, Cook A, et al. Late incompetence of the left atrioventricular valve after repair of atrioventricular septal defects: The morphologic perspective. J Thorac Cardiovasc Surg, 2006, 132(3): 640-646.
16. Moorjani N, Rana BS, Wells FC. Annular dilatation. In: Operative Mitral and Tricuspid Valve Surgery. Berlin: Springer, 2018.113-121.
17. Yamauchi T, Taniguchi K, Kuki S, et al. Evaluation of the mitral valve leaflet morphology after mitral valve reconstruction with a concept "coaptation length index". J Card Surg, 2005, 20(5): 432-435.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Twenty-two patients of atrioventricular septal defect repair with prosthetic valve ring implantation: A retrospective cohort study in a single center

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