Survival and Probability of Cure Without and With Operation in Complete Atrioventricular Canal
1979; Elsevier BV; Volume: 27; Issue: 2 Linguagem: Inglês
10.1016/s0003-4975(10)63249-3
ISSN1552-6259
AutoresThomas J. Berger, Eugene H. Blackstone, John W. Kirklin, L.M. Bargeron, Jane B. Hazelrig, Malcolm E. Turner,
Tópico(s)Cardiac Valve Diseases and Treatments
ResumoActuarial analysis based on postmortem examination of patients who had been treated nonsurgically for complete atrioventricular (A-V) canal defect shows that only 54% survive to 6 months of age, 35% to 12 months, 15% to 24 months, and 4% to 5 years of age.Our surgical experience since 1975 in 39 patients confirms the idea that primary repair is feasible in small infants.The highest risk of hospital death is when the operation is done in the early months of life; it falls to 17% by age 12 months.Between 1967 and October, 1976, the fiveyear survival rate among patients leaving the hospital alive after repair was 91%.The age-specific probability of "surgical cure" of patients operated upon for complete A-V canal (alive five years later .withmean pulmonary artery pressure less than 25 mm Hg) is maximal at 73% when the operation is done at about 14 months of age.Urgent earlier repair is frequently necessitated by the life history of the disease.A trend has recently developed toward earlier primary repair in patients with the completc form of common atrioventricular (A-V) canal defect [l, 2, 5, 11, 121.The risk of operation is somewhat higher in young infants than in older children [131.This raises questions concerning the long-term results of this trend, and concerning the relative benefits of this patient management program compared with others.Therefore, we have studied the age-specific survival without surgical treatment of indi-
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