CAVSDs are associated with high-flow systemic pressure in the pulmonary vasculature leading to fibrosis
نویسندگان
چکیده
The ideal timing for repair of CAVC malformations remains controversial. Some authors advocate primary repair at the age of six months or earlier before the onset of irreversible pulmonary hypertension especially in the presence of Down syndrome. Others suggest two-stage repair consisting of pulmonary artery banding as a first stage followed by complete repair thereafter. The aim of this work was to evaluate the results of early total repair of CAVCD before six months of age with the hypothesis that, with modern techniques, the current risks of CAVSD repair in children younger than 6 months and those older than 6 months are equal. Patients & Methods: Twenty patients (11 females 9 males) below 6 months of age with isolated CAVC (study group) undergone primary total repair of CAVC defect. Another 20 patients (12 females & 8 males) with CAVC who undergone repair above the age of 6 months were selected for comparison (control group). The mean age in the study group was 5.3+0.49 & 12+ 8.5 months in the control group. While the mean body weights were 4.7 + 0.45& 9+ 2.5 Kg respectively. Nine patients of the study group (45%) and in 10 patients (50%) of the control group suffered from Down syndrome. Results: There was no statistical difference in intra-operative and postoperative data between both groups, except for the duration of mechanical ventilation which was longer in the control group (48 + 20 hours) than in the study group (36 + 15 hours) and the incidence of recurrent postoperative pulmonary hypertensive crises which was higher in the control group (8 patients) than in the study group (4 patients).On the other hand the durations of ICU & hospital stay were higher in the study group (5+1 &10+ 1.5 days respectively) than in the control group (4+0.88 & 9+1.27 days respectively. Conclusion: We concluded that with modern techniques, the current risk factors for CAVSD repair in patients younger than 6 months and in those older than 6 months are equal.
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