Predictors of repair and outcome in prenatally diagnosed atrioventricular septal defects

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
Andrea Z BeatonMary T Donofrio

Abstract

Atrioventricular septal defect (AVSD) is a common prenatal diagnosis with great heterogeneity. Few data guide counseling about outcomes and types of repair. The aim of this study was to describe predictors of survival and repair type in prenatally diagnosed atrioventricular septal defect. A retrospective review of fetuses diagnosed with AVSD was conducted. Of 106 fetuses with AVSDs, outcome data were available in 88, 66 with situs solitus and 22 with heterotaxy. Overall mortality was 52%, with 66% surviving to birth, 58% to 1 month, and 47% to 1 year. There was increased mortality in patients with heterotaxy (P = .02). In patients with situs solitus, there was increased mortality in those with unbalanced AVSDs (P < .01). The presence of a chromosomal abnormality did not affect mortality (P = .34). In pregnancies with intent to continue (n = 60), 97% of patients survived to birth, 86% to 1 month, and 69% to 1 year. The presence of heterotaxy (P < .01) or other complex intracardiac disease (P < .01) was associated with single-ventricle repair. In patients with unbalanced AVSDs who underwent surgery, two-ventricle repair was uncommon (29%), but it was performed more often in those with restrictive ventricular septal defects (71%)....Continue Reading

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