Is there an Upside for Down’s Syndrome: Reintervention after Complete Atrioventricular Septal Defect Repair

Background: Reoperation rate after a complete repair of atrioventricular septal defect (AVSD) remains as high as 10–15%. Reoperation is most often required for left atrioventricular valve regurgitation (LAVVR), followed by left ventricular outflow tract obstruction (LVOTO) and residual VSD. Down’s syndrome does not appear to be a risk factor for operative mortality and it has been associated with lower reoperation rates in the past. In this study, we reviewed our 17 years’ experience with complete AVSD repair and compared the short and long-term outcomes of Down’s versus non-Down’s syndrome.

Methods: This is a retrospective study including all patients who underwent complete AVSD repair from 2007 to 2024.

Results: (In progress)

A total of 110 patients were included in the cohort, of them 71 (64%) were born with Down’s syndrome and 39 (36%) were chromosomally normal. The mean age and weight at time of repair were 8.8 month and 5938 grams with no statistically significant differences between the groups. Similar preoperative conditions and baseline characteristics were present between the groups. In terms of surgical repair, the duration of the procedures and the type of repair were also similar between the groups. Among the 110 patients undergoing complete AVSD repair there was only one mortality case, which included a Down’s syndrome patient, who was born with obstructed TAPVC. With mean follow-up period of 46 months (range, 0.4-157 months), 5 (12.8%) in the non-Down’s group and 12 (16.6%) in the Down’s syndrome group required reintervention. Statistical data regarding the type of reintervention and the rate between the groups is pending.

Conclusions: According to the data presented in this study, Down’s syndrome has not proven to be a protective factor from reintervention, as it was previously described. Complete AVSD repair can be achieved with zeroed mortality in a high volume congenital cardiovascular center.