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首页> 外文期刊>Journal of cardiac surgery. >Reoperation for left atrioventricular valve failure in repaired atrioventricular septal defect: Can more valves be preserved in the current era?
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Reoperation for left atrioventricular valve failure in repaired atrioventricular septal defect: Can more valves be preserved in the current era?

机译：在修复的房室间隔缺损中重新进入左侧房室缺陷：可以在当前的时代保存更多的阀门吗？

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Abstract Objective Left atrio‐ventricular valve (LAVV) regurgitation after repair of an atrio‐ventricular septal defect (AVSD) may necessitate further surgery. However, redo‐LAVV repair remains challenging. We sought to determine if more LAVV valves are preserved in the current era, and analyze early and longer‐term results. Patients All consecutive patients with repaired AVSD who underwent redo‐LAVV surgery from January 2004 to April 2017 were included. Patients with single ventricles, atrial isomerism, and complex associated anomalies were excluded. Methods This was a single‐center study using retrospective chart review and an institutional database for follow‐up information. Data analyzed included number and year of primary AVSD and redo‐LAVV operation, presence of trisomy 21, morphology of AVSD, mortality, and reoperation. Univariate analysis included repair and replacement rates and early and long‐term survival. Results During the study period 36 redo‐LAVV operations were performed, with repair in 28 and replacement in eight. The number of redo‐operations increased from 13 in the first part to 23 in the second part of the study. The rate of LAVV preservation significantly increased over time (54% vs 91%, P ??0.01), and was not affected by morphology of AVSD or trisomy 21. There was one in‐hospital death at Day 42 and overall estimated survival was 94.5% at 5 years. Freedom from reoperation after redo‐LAVV repair was 87% at 5 years with no significant difference between repair and replacement groups. Conclusion In the current era, more LAVVs can be preserved at the time of redo‐operation with excellent early and long‐term survival and acceptable reoperation rates. LAVV morphology and presence of trisomy 21 did not affect outcome.
机译：摘要目的房室间隔缺损（AVSD）修补术后左房室瓣（LAVV）返流可能需要进一步手术治疗。然而，重做LAVV修复仍然具有挑战性。我们试图确定在当前时代是否保存了更多的LAVV阀门，并分析早期和长期结果。患者包括2004年1月至2017年4月期间接受过redo-LAVV手术的所有连续AVSD修复患者。排除单心室、心房异构和复杂相关异常的患者。方法这是一项单中心研究，采用回顾性图表回顾和机构数据库进行随访。分析的数据包括原发性AVSD和重做LAVV手术的次数和年份、21三体的存在、AVSD的形态、死亡率和再次手术。单变量分析包括修复率、替换率以及早期和长期生存率。结果在研究期间，共进行了36次重做LAVV手术，其中修复28例，更换8例。重做操作的数量从第一部分的13次增加到第二部分的23次。LAVV保存率随时间显著增加（54%对91%，P＜0.01），且不受AVSD或21三体的形态学影响。第42天时有一例住院死亡，5年时总估计生存率为94.5%。5年后，再次LAVV修复后再次手术的自由度为87%，修复组和置换组之间无显著差异。结论在目前的时代，在再次手术时可以保留更多的LAVV，具有良好的早期和长期生存率以及可接受的再次手术率。LAVV形态和21三体的存在不影响预后。

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