Background This study aimed to present the short- and midterm outcomes after complete atrioventricular canal defect (CAVC) repair using a single-patch technique.
Methods This study included 30 children who underwent surgical correction of the CAVC using a single-patch technique.
Results The median age of the patients was 5.7 months (interquartile range [IQR], 5.0–7.5 months), and 23 patients (76.7%) had type A CAVC. Fourteen patients (46.7%) were female and 17 (56.7%) had been diagnosed with Down syndrome. The in-hospital mortality rate was 0%. No deaths were observed during a median follow-up of 4 years (IQR, 3.5–5.0 years). Patients without Down syndrome were associated with late moderate mitral regurgitation (MR) (p=0.02). Late MR less than moderate degree was observed in 96.6%, 78.5%, and 50% of patients after 2, 4, and 5 years of follow-up, respectively, while late tricuspid valve regurgitation less than moderate degree was observed in 96.7%, 85.9%, and 59.0% of patients after 2, 4, and 6 years of follow-up, respectively. After a median follow-up of 4 years, only one patient had required surgical repair of a left ventricular outflow tract obstruction, which occurred 26 months after the first operation. Multivariable logistic regression analysis adjusted for the type of CAVC, sex, Down syndrome, age, and weight revealed that the absence of Down syndrome was a risk factor for late moderate MR (MR-2) (odds ratio, 0.05; 95% confidence interval, 0.006–0.50; p=0.01).
Conclusion A single-patch technique for CAVC surgical repair is a safe method with acceptable short- and midterm results.
BACKGROUND Echocardiography is rapidly established itself as the primary diagnostic technique for investigation of children with heart disease, and referrals are increasing to the pediatric cardiology clinic for investigation. However, because there is a lack of analysis data on the patients referred to pediatric cardiology clinics, we have proceeded to compare and analyze their characteristics to provide basic data base. METHODS: From Oct. 1, 1998 to Jul. 10, 1999, total 443 cases referred to the pediatric cardiology clinic of Yeungnam University Hospital were studied retrospectively by medical records, chest X-ray, EKG and echocardiography, etc. RESULTS: The results were as follows. 1. The proportion of male was 61.0%(261 cases) and that of female was 39.0%(167 cases). The ratio of male to female was 1.6:1. The proportion infants less than 1 year-old was 62.6%(268 cases) of all patients. 2. Cardiac murmur was present in 248 cases(57.9%), which was the most common case of referral to the pediatric cardiology clinic. The impression at referral was more congenital heart disease(70.6%) than acquired heart disease(17.8%) and arrhythmia(11.6%). 3. The final diagnosis was as follows : congenital heart disease was present in 212 cases(49.5%), acquired heart disease, 59 cases(13.9%); arrhythmia, 13 cases(3.0%); normal heart, 144 cases(33.6%). CONCLUSION: Among the patients referred to pediatric cardiology clinic, 33.6%(144 cases) had normal hearts and why these patient were referred may be possibly due to more dependence on echocardiography than on auscultation instruction. Threfore, clinical and auscultatory skill should be emphasized to minimize dependence on expensive echocardiography for evaluation of pediatric heart disease.
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Evaluation and diagnostic approach for heart murmurs in children Hee Joung Choi Journal of the Korean Medical Association.2020; 63(7): 398. CrossRef