Endocardial Cushion Defect

Abstract

Preoperative and postoperative data on 44 patients with endocardial defect, 32 with the incomplete and 12 with the Complete form are presented. Nineteen per cent of the incomplete form died with per cent of the deaths occurring early and 9.5 per cent late. The mortality rate for the complete form was 75 per cent. Late follow-up results were evaluated in 28 patients 1 to 2½ years following surgery. Catheterization data in nine of 10 and clinical observations in 18 indicated no residual shunt. One patient showed questionable evidence of a left-to-right shunt by cardiac catheterization. Evidence of mitral regurgitation was present in seven (25 per cent) of the survivors. Short chordae attaching the closed cleft margin of the mitral leaflet to the ventricular septum rendered the valve incompetent in nine of 12 autopsied specimens. Surgical exploration of the underside of the cleft margins for such chordae is recommended. No evidence of residual tricuspid regurgitation was found.