Comment
is classified into four groups: complete, partial with an isolated
primum ASD, partial with an isolated inlet VSD and intermediate type.
Intermediate AVSD is anatomically characterized by the presence of an
ostium primum atrial septal defect occupying the portion of the atrial
septum just superior to the separately formed RAVV and LAVV, and varying
degrees of clefting of the anterior leaflet of the LAVV [1, 3].
Intermediate type AVSD is less frequent than complete or partial AVSD,
and is tartly encountered in the adulthood [4].
Complete AVSD presents early in life, and unless treated expediently
develop into irreversible pulmonary vascular disease. Presentation of
incomplete or intermediate AVSD is more variable. The optimum age for
repair of incomplete AVSD is 3 to 5 years, but some patients diagnosed
by presenting congestive heart failure symptoms in adult [5]. The
outcome is excellent after the repair of incomplete AVSD in childhood.
Michael et al. reported the long-term survival after repair of
incomplete AVSD in adult [2]. Pulmonary arterial hypertension,
complete AV block and atrial arrhythmias were the risk factors of
mortality and morbidity. They recommended the early surgery for AVSD to
reduce the risk because older patients are more likely to present with
atrial arrhythmia and moderate or severe RAVV regurgitation.
Our patient was fortunately
detected incidentally before having bad preoperative condition.
Moreover, her cardiac function was preserved without any arrhythmia. We
believe that it is important for cardiologist to know there is a chance
to see patient with AVSD without symptoms incidentally in adulthood.