Complete Atrioventricular Septal Defect – Evolution of Results in a Single Center during 50 years

Abstract Background Operative mortality after complete atrioventricular septal defect (cAVSD) repair has improved vastly. Less improvement has been demonstrated regarding late mortality and reoperation rates. There is evident lack of comprehensive population-based studies analyzing the history and progress of the ever-changing operative results. Methods This is a 5-million population-based retrospective study of consecutive 388 cAVSD patients operated in Finland between 1962 and 2014. Data was collected using Children’s Cardiac Surgical Registry of Children’s Hospital at the Helsinki University Hospital, Finland. Mortality data and reoperation rates were analyzed on a decade-by- decadebasis. Results During the early era, overall mortality was 17.4%, operative mortality comprising 10.9%. The operative results have improved significantly over the decades, and eventually, the last decadeshowed no mortality. Total of 23 late deaths occurred; of these, 20 were directly heart-related. Half of the late mortality occurred during the first postoperative year. The only significant risk factor for overall mortality was an earlier decadeof operation (p Conclusions There has been an outstanding improvement in surgical results through years even though the general operative approach has remained the same. Rates of reoperation have not been declining, but the reoperations are dated to early childhood years. The improvement in results has been ongoing.