FREQUENCY OF LEFT ATRIOVENTRICULAR REGURGITATION POSTOPERATIVELY AFTER REPAIR OF COMPLETE ATRIOVENTRICULAR DEFECT

Experience with 43 consecutive cases of isolated (except for patent ductus) atrioventricular (AV) defects treated surgically at University Medical Center in Tucson, Arizona, were reviewed to determine occurrence and amount of postoperative left AV valve regurgitation. Patients initially evaluated at ages 1 day to 59 months were included, 32 of whom had Down's syndrome and 11 of whom had normal chromosomes. Age at repair ranged from 1 month to 171 months; 70% of patients had repair at < 16 months of age. Mean follow up was 7.1 years. Nine patients died, 8 of whom had Down's syndrome. Left AV valve regurgitation was absent or mild in 69% of patients who survived the perioperative period; however, very early repair (age less than or equal to 4 months) was associated with significantly greater probability of moderate or severe left AV valve regurgitation than that seen in patients who had repair after that age. These data suggest that left AV valve regurgitation after repair of AV defects is usually not clinically significant, but patients in this series who underwent operation very early (age less than or equal to 4 months) were at the highest risk for significant left AV valve regurgitation.