Between May 1991 and August 1993, 16 patients underwent repair of complete atrioventricular septal defect without another major anomaly at Cardiovascular Center, Yonsei University College of Medicine. Ages of the patients ranged from 3 months to
38
years with a mean of 42 months. Among 16, 10 patients(63%) are associated with Down's syndrome.
All patients underwent primary repair except one who received had been repaire of coactation of aorta and patent ductus arteriosus 2 month before. Preoperative mitral valve regurgitation(MR) was evaluated with Doppler echocardiography and
angiography
which revealed absent or grade I in 1, grade II in 8, grade III in 4, and grade IV in 3.
Operative technique was performed under the moderate hypothermic cardiopulmonary bypass with crystalloid cardioplegia. Intraoperative echocardiography was performed epicardial approach(n=7) in the operative table or transthoracic approach(n=9) at
intensive care unit.
In all patients except 3, MR were improved. But in 3 patients, was not improved or exagerated comparing preoperative one. All of them were died.
One patient was showed MR grade IV in intraoperative echocardiography, we re-repaired atriventricular valve with cardiopulmonary bypass.
During follow-up period(at a mean of 11 months after repair), doppler echocardiography was performed in all patients.
The follow up echocardiography revealed that the degree of MR in immediate postoperative period was not changed except in two patients in whom it was aggravated.
Thus it seems that intraoperative and early postoperative echocardiography was employed important role of survival and can be predictable for long term results. (Korean J Thoracic Cardiovas Surg 1994; 27:902-6)
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