RESUMEN
This study included 60 patients with repaired AVSD that were scanned by 2-D echocardiography to detect and evaluate the degree of residual mitral regurge [MR] and to assess the cardiac function. The preoperative data including age, weight, associated anomalies or Down's syndrome and two-dimensional echocardiography were reviewed. Using real time 3-D echocardiography, the three components of mitral valve [superior, inferior and lateral or mural leaflets] surface areas were measured in 20 out of these 60 patients. A common AVV orifice was present in 73.3% [first group] and the rest had separate AVV orifice [second group]. The prevalence of associated cardiac anomalies was significantly higher in the first group. Down's syndrome was present in 22 cases, 12 of them in the first group and 10 in the second group. It was also observed that late repair [<1 year] was a risk factor for postoperative MR. So, the first year of life is the golden time for definitive repair of AVSD. It can be concluded that late [>12 months] repair of AVSD and associated cardiac anomalies were identified to be significant risk factors for the persistence of MR postoperatively. To improve the surgical results of AVSD repair, operation should be best done before the first year of life. Real time 3-D echocardiography preoperative scanning of the surface areas of the mitral valve leaflets may give a guide to the best procedure of repair. Real time 3-D echocardiography avoids deficiencies encountered with reconstructive 3-D techniques by acquiring volumetric data at a rate sufficient to show real time movements of the heart and intracardiac structures in a very short time