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  • Atrial fenestration...

Atrial fenestration during AVSD repair associated with increased mortality

Written By : Hina Zahid |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-01-26T13:00:17+05:30  |  Updated On 26 Jan 2022 12:58 PM IST
Atrial fenestration during AVSD repair associated with increased mortality
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Boston, MA - A new study, presented today at the AATS 101st Annual Meeting, shows an association between decreased survival at five years and leaving an atrial communication at biventricular repair of unbalanced AVSD after adjusting for other known risk factors. During repair of atrioventricular septal defect (AVSD), surgeons may leave an atrial level shunt when they have concerns about postoperative pulmonary hypertension, a hypoplastic right ventricle (RV), hypoplastic left ventricle (LV), or as part of their routine practice. The study sought to determine factors associated with mortality after biventricular repair of AVSD.

The study included 581 patients enrolled from 31 Congenital Heart Surgeons' Society (CHSS) institutions from Jan. 1, 2012 - June 1, 2020. Parametric multiphase hazard analysis was used to identify factors associated with mortality. A random effect model was used to account for possible inter-institutional variability in mortality.

An atrial fenestration was placed during biventricular repair in 23 percent of patients. Overall, five-year survival after repair was 91 percent. The atrial fenestration group had an 83 percent five-year survival compared to 93 percent in the non-fenestrated group. According to Connor Callahan, the John W. Kirklin/David Ashburn Fellow of the Congenital Heart Surgeons' Society Data Center and University of Toronto, General Surgery Resident at Washington University/Barnes-Jewish Hospital, "Atrial fenestration was associated with reduced long-term survival in our study. As a result of these findings, institutions and surgeons that routinely use fenestration may reevaluate its role in their practice."

While leaving an atrial communication at biventricular repair of unbalanced AVSD is associated with significantly reduced long-term survival after adjusting for other known risk factors, it is unknown whether this association is causal or related to unmeasured factors, or a combination of both. The impact of fenestration can optimally be derived from a randomized clinical trial in the future.


hypoplastic left ventricleatrial fenestrationmortalityatrioventricular septal defectpostoperative pulmonary hypertension
Source : AATS 101st Annual Meeting
Hina Zahid
Hina Zahid

    Hina Zahid Joined Medical Dialogue in 2017 with a passion to work as a Reporter. She coordinates with various national and international journals and association and covers all the stories related to Medical guidelines, Medical Journals, rare medical surgeries as well as all the updates in the medical field. Email: editorial@medicaldialogues.in. Contact no. 011-43720751

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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