FATE OF MITRAL REGURGITATION FOLLOWING REPAIR OF ATRIOVENTRICULAR SEPTAL-DEFECT

The purpose of this study was to evaluate the fate of mitral regurgita tion (MR) following repair of atrioventricular septal defects (AVSDs). Echocardiograms of all survivors of isolated AVSD surgery between 198 6 and 1996, who had had greater than or equal to 2 postoperative color Doppler studies (39 patients), were reviewed, On each study, MR sever ity was graded on a 1+ to 4+ scale, based upon the size of the MR jet, Median age at surgery was 9 months (range 3 to 169); median age at po stoperative follow-up was 45 months (range 3 to 107), Mild deteriorati on of mitral valve function was fairly common, MR severity increased b y greater than or equal to 1 grade in 16 patients (41%) during the cou rse of the study, However, the deterioration in mitral valve function occurred primarily during the early postoperative time intervals, Afte r the initial 32 postoperative months, MR worsened on only 4 occasions and in each instance worsened by only 1 grade. Deterioration to 4+ MR occurred in only 3 patients, and was not observed after the initial 3 0 postoperative months, Survival curve analysis predicted a 90% probab ility of not having severe (4+) MR after 30 months (lower 95% confiden ce bound: 80%). Postoperative MR remains fairly stable following AVSD repair, Serious deterioration is rare, especially after the initial 30 postoperative months, (C) 1997 by Excerpta Medica, Inc.