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Background: Repair of partial or transitional atrioventricular septal defects (P/T AVSD) has excellent outcomes; however, late reinterventions remain a concern. Technical Performance Score (TPS) measures residua post repair and has been associated with early/mid-term outcomes after congenital cardiac surgery. We investigated TPS as a predictor of outcomes in P/T AVSD repair.
Methods: Single center retrospective review of P/T AVSD repair from 7/2000 to 11/2015. Intraoperative and discharge TPS were assigned based on echocardiographic criteria: class 1-no residua, class 2-minor residua, and class 3-major residua or reintervention for major residua. Intensive care unit (ICU)/hospital length of stay and post-discharge reintervention were analyzed using Cox regression.
Results: Of 183 patients, 124 (68%) and 59 (32%) underwent P/T AVSD repair respectively. Median age was 1.5 (IQR 0.6, 3.8) years, median weight was 9.7 (IQR 6.6, 14.1) kg, and 96 (52%) were female. There were 20 (11%) post-discharge reinterventions. On multivariable modeling, patients with class 3 TPS spent more days in the ICU (HR 0.33, CI 0.19, 0.58; p<0.001) and hospital (HR 0.38, CI 0.22, 0.64; p<0.001) and had shorter time to post-discharge reintervention (HR 8.76, CI 1.03, 74.7, p=0.05); table.
Conclusions: TPS may identify those with prolonged ICU/hospital stay and post-discharge reinterventions, providing feedback on areas of improvement in technique and identification of patients who warrant closer follow-up.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Congenital Heart Disease: Progress in Pediatric Heart Surgery
Abstract Category: 10. Congenital Heart Disease: Pediatric
Presentation Number: 1101-017
- 2017 American College of Cardiology Foundation