Abstract
Abstract
Introduction:
Discrepancies between preoperative echocardiographic diagnosis and intraoperative surgical findings for incomplete atrioventricular septal defects are frequently encountered. We assess the frequency of diagnostic discordance and its impact, focusing on subtype-specific predictors of the postoperative course.
Methods:
We reviewed 172 patients post repair of incomplete atrioventricular septal defects at a single institution between November 2000–February 2025, including transitional atrioventricular septal defects (
n
= 74), partial atrioventricular septal defects (
n
= 71), and primum atrial septal defect with isolated left atrioventricular valve cleft (
n
= 27). Preoperative echocardiographic diagnoses were compared with intraoperative surgical diagnoses to determine diagnostic discordance and assess impact.
Results:
Baseline characteristics were similar across subtypes. Transitional atrioventricular septal defects were associated with a higher prevalence of syndromic diagnoses (52.7% versus 33.8% versus 22.2%,
p
= 0.008) and greater preoperative ventricular dilation (LVIDd
Z
-score −0.88 versus −1.70 versus −1.70,
p
= 0.031). Diagnostic discordance occurred most frequently in partial atrioventricular septal defects (74.6%), followed by primum atrial septal defect with isolated left atrioventricular valve cleft (37.0%) and transitional atrioventricular septal defects (13.5%) (
p
p
p
p
= 0.643), and follow-up duration differed modestly between groups (
p
= 0.047).
Conclusion:
The high rate of diagnostic discordance reflects inherent challenges in preoperative classification and suggests that a simplified, clinically oriented nomenclature may improve communication, surgical planning, and outcome prediction.