{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T08:06:45Z","timestamp":1784707605771,"version":"3.55.0"},"reference-count":12,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,5,26]],"date-time":"2024-05-26T00:00:00Z","timestamp":1716681600000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In infants with complete atrioventricular canal (CAVC) defects, post\u2010operative left atrioventricular valve regurgitation (LAVVR) is a known major cause of morbidity and mortality and a common indication for re\u2010operation. However, there is scarce data to identify risk factors for poor outcomes. Our study aims to find echocardiographic characteristics that predict post\u2010operative LAVVR at discharge and 1\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study of patients with initial CAVC repair at our hospital who were followed for 1 year between 2013 and 2022. Patients with major co\u2010morbid conditions were excluded. Serial echocardiograms were reviewed. Anatomic details, quantitative and qualitative measure of LAVVR including the number of regurgitant jets, regurgitant jet length and vena contracta width, and ventricular function were collected. The time points measured include pre\u2010operative transthoracic echocardiogram (TTE), post\u2010operative transesophageal echocardiogram (PO\u2010TEE), routine protocol based post\u2010operative day 1 (POD1) TTE, discharge TTE and 1\u2010year post\u2010operative (1yPO) TTE. Paired <jats:italic>t<\/jats:italic>\u2010tests, chi\u2010square analysis, and linear regression analysis were performed comparing measured variables to LAVVR outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010two patients were included; 92% had Trisomy 21. The majority were classified as Rastelli A (71%), others Rastelli C (29%). Only two patients had moderate or greater LAVVR pre\u2010operatively. The mean age at repair was 125 \u00b1 44 days. Pre\u2010operative LAVVR was the only significant predictor of LAVVR severity at 1 year after backward stepwise regression.<\/jats:p><jats:p>Of those with\u00a0&lt;\u00a0moderate LAVVR on PO\u2010TEE, 20% had worsening to\u00a0\u2265\u00a0moderate at discharge, but only 9% remained that way at 1 year. Of those with\u00a0\u2265\u00a0moderate LAVVR on PO\u2010TEE, 40% improved to\u00a0&lt;\u00a0moderate by 1 year. Two patients who worsened at 1 year, both secondary to likely cleft suture dehiscence. Only one patient required reoperation in the immediate post\u2010operative period secondary to severe LAVVR due to suture dehiscence. Routine protocol\u2010based POD1 echo did not have any association with altered outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pre\u2010operative LAVVR was the only significant predictor of LAVVR severity at 1 year. A significant percentage (40%) of patient with\u00a0\u2265\u00a0moderate LAVVR on PO\u2010TEE improved to\u00a0&lt;\u00a0moderate by 1 year. Furthermore, routine protocol\u2010based POD1 echo did not have any association with altered outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15832","type":"journal-article","created":{"date-parts":[[2024,5,26]],"date-time":"2024-05-26T10:59:56Z","timestamp":1716721196000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Predictors of post\u2010operative left atrioventricular valve regurgitation in pediatric patients with complete atrioventricular canal defects"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5478-5016","authenticated-orcid":false,"given":"Kaitlyn","family":"Freeman","sequence":"first","affiliation":[{"name":"Department of Pediatrics Division of Cardiology Massachusetts General Hospital for Children, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Caris","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Cardiology UPMC Children's Hospital of Pittsburgh University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy H.","family":"Schultz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Cardiology Children's Hospital of Philadelphia and Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5738-0786","authenticated-orcid":false,"given":"William","family":"Tressel","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Collaborative Health Studies Coordinating Center University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Kronmal","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Collaborative Health Studies Coordinating Center University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujatha","family":"Buddhe","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.09.043"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2004.07.010"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezab221"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2010.03.108"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/s104795110600076x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.102.suppl_3.iii\u2010160"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/2150135119893648"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2010.06.008"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivy023"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2015.05.011"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2015.01.063"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1510\/icvts.2008.195180"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.15832","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,26]],"date-time":"2024-05-26T11:11:19Z","timestamp":1716721879000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.15832"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":12,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/echo.15832"],"URL":"https:\/\/doi.org\/10.1111\/echo.15832","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5]]},"assertion":[{"value":"2024-02-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e15832"}}