{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:19:40Z","timestamp":1787242780846,"version":"build-2736575974"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"S 03","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":86,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This single-center study investigated long-term outcomes after surgical correction of atrioventricular septal defect (AVSD).<\/jats:p>\n                  <jats:p>A total of 248 patients underwent biventricular repair for AVSD between 1995 and 2022. A total of 208 (83.9%) patients had complete (cAVSD), 29 (11.7%) partial (pAVSD), and 11 (4.4%) transitional AVSD (tAVSD). Associated cardiovascular anomalies were present in 88 (35.5%) cases and 61 (24.6%) patients were born prematurely. Median age at repair was 7.1 for cAVSD, 23.7 for pAVSD, and 13 months for tAVSD.<\/jats:p>\n                  <jats:p>Overall survival or reoperation incidence did not differ significantly between AVSD types and improved significantly over surgical eras. Survival of the entire cohort was 88.3% at 10, 83.8% at 15, and 79.6% at 25 years. Prematurity (hazard ratio [HR]: 2.43, p\u2009=\u20090.029), low weight (&lt;4\u2009kg) (HR: 3.05, p\u2009=\u20090.028), and partial cleft closure (HR: 2.43, p\u2009=\u20090.037) were independent risk factors for mortality. Forty-eight patients (19.4%) underwent a total of 64 reoperations over the study period. The main indication for reoperation was left atrioventricular valve regurgitation (LAVVR) with 55\/64 procedures. However, 36% of procedures were performed to address several lesions, with left ventricular outflow tract obstruction being the second most common indication. Freedom from reoperation was 78.2, 75.8, and 72.5% at 10, 15, and 25 years, respectively. The incidence of reoperation increased significantly in association with early postoperative LAVVR \u2265 I\u2013II\u00b0 (HR: 2.6, 95% confidence interval [CI]: 1.4\u20134.7, p\u2009=\u20090.002) and presence of residual cardiac defects (HR: 2.0, 95% CI: 1.1\u20133.6, p\u2009=\u20090.018).<\/jats:p>\n                  <jats:p>While LAVVR is the main indication for reoperation, a significant proportion of procedures address additional pathologies. Premature patients and those with associated cardiovascular anomalies should receive special attention during postoperative follow-up.<\/jats:p>","DOI":"10.1055\/a-2536-8640","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T20:18:37Z","timestamp":1743193117000},"page":"e11-e20","source":"Crossref","is-referenced-by-count":4,"special_numbering":"S","title":["A 27-Year Experience with Atrioventricular Septal Defect Correction"],"prefix":"10.1055","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7886-9089","authenticated-orcid":false,"given":"Mina","family":"Farag","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Division of Congenital Cardiac Surgery, Heidelberg University, Congenital, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mireia","family":"Isern Hacker","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Division of Congenital Cardiac Surgery, Heidelberg University, Congenital, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Grieshaber","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Division of Congenital Cardiac Surgery, Heidelberg University, Congenital, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Fonseca Escalante","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Division of Congenital Cardiac Surgery, Heidelberg University, Congenital, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Karck","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Division of Congenital Cardiac Surgery, Heidelberg University, Congenital, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raoul","family":"Arnold","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology, Heidelberg University, Congenital, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Gorenflo","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology, Heidelberg University, Congenital, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsvetomir","family":"Loukanov","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Division of Congenital Cardiac Surgery, Heidelberg University, Congenital, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"issue":"07","key":"ref1","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1017\/S104795112100281X","article-title":"Nomenclature for pediatric and congenital cardiac care: unification of clinical and administrative nomenclature - the 2021 International Paediatric and Congenital Cardiac Code (IPCCC) and the Eleventh Revision of the International Classification of Diseases (ICD-11)","volume":"31","author":"J P Jacobs","year":"2021","journal-title":"Cardiol Young"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1016\/j.athoracsur.2021.07.096","article-title":"Propensity score matched analysis of cleft closure in complete atrioventricular septal defect repair","volume":"113","author":"E Buratto","year":"2022","journal-title":"Ann Thorac 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Annu"}],"container-title":["The Thoracic and Cardiovascular Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2536-8640.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T20:19:54Z","timestamp":1743193194000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2536-8640"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":32,"journal-issue":{"issue":"S 03","published-online":{"date-parts":[[2025,3,4]]},"published-print":{"date-parts":[[2025,1]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2536-8640","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0171-6425","1439-1902"],"issn-type":[{"value":"0171-6425","type":"print"},{"value":"1439-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}