Kết quả trung hạn phẫu thuật sửa chữa bệnh thông sàn nhĩ thất toàn bộ tại Bệnh viện Nhi Trung ương

Abstract

Objective: To evaluate the midterm outcome for surgical repair of complete atrioventricular septal defect and the risk factors affect to the surgical results at Children Heart Center, National Children’s Hospital. Subject and method: We retrospective evaluated midterm outcome of patients who underwent surgical correction of complete atrioventricular septal defect from April 2015 to July 2019. Result: There were 51 patients who underwent surgical repair for complete atrioventricular septal defect in the period study. The median age was 263 days (range, 95 - 3478 days), the median weight was 5.8kg (range, 3.7 - 23.0kg). There was a significant difference in the time of cardiopulmonary bypass and aortic cross clamp time between group using modified single-patch technique and two patch technique (p<0.05). There were 5 patients died in-hospital (9.8%). Univariate analysis revealed two factors associated with hospital mortality: Pre-operative mechanical ventilation (p=0.005), and post-operative severe left atrioventricular valve regurgitation (p<0.000). At the latest follow-up with 46 patients, there were 2 late deaths. Reoperation required in 2 patients due to severe mitral valve regurgitation. The mean follow-up time was 16.23 months (range, 3 - 58 months), with 29 patient (63%) have no mitral regurgitation or trivial, 16 patients have mild-to-moderate (34.8%), and 1 patient had moderate-severe (2.2%). Multivariate analysis with regard to mortality revealed post-operative left atrioventricular valve regurgitation was risk factor for hospital mortality with p=0.021. Conclusion: Surgical correction for complete atrioventricular septal defect at Children Heart Center-Vietnam National Children’s Hospital can be performed in infancy with a good midtern outcome, and a low rate of reoperation for mitral valve regurgitation. Severe mitral valve regurgitation postoperative was a risk factor for hospital mortality.