Research Article

Our experience with single patch repair of complete atrioventricular septal defects

Can Vuran*, Uygar Yoruker, Oguz Omay, Bulent Saritas, Canan Ayabakan, Ozlem Sarisoy and Riza Turkoz

Published: 05/02/2020 | Volume 5 - Issue 2 | Pages: 105-108

Abstract

Background: Various surgical methods have been utilized in the management of complete atrioventricular septal defects (CAVSD). Early intervention and achievement of a competent left atrioventricular valve are the key factors for successful treatment.

Methods: A total of 66 patients with complete atrioventricular septal defect have been operated in a tertiary care center. Patient group consisted of 28 males and 38 females with an average age of 6.2 ± 3.3 months. Ventricular and atrial defects were repaired generally with single-patch technique using autogenous pericardium.

Results: Preoperative catheterization and angiography was performed in 41 patients. Single patch and modified single patch techniques were preferred in 57 and 9 patients respectively. The average duration for respiratory support, intensive care unit stay and discharge from hospital were 36 ± 49.3 hours, 4.1 ± 1.9 days, and 10.1 ± 3.3 days respectively. In the left atrioventricular valve mild, moderate and severe regurgitation were detected in 44 (66.6%), 17 (25.7%) and 2 (3%) patients postoperatively. No regurgitation was determined in 3 patients (4.5%). Two cases ended up with mortality (3%).

Conclusion: Single patch repair technique can provide satisfactory surgical outcomes in patients with complete atrioventricular septal defect.

Read Full Article HTML DOI: 10.29328/journal.jccm.1001095 Cite this Article

References

  1. Redmond JM, Silove ED, De Giovanni JV, Wright JG, Sreeram N, et al. Complete atrioventricular septal defects: the influence of associated cardiac anomalies on surgical management and outcome. Eur J Cardiothorac Surg. 1996; 10: 991-995. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/8971512
  2. Kobayashi M, Takahashi Y, Ando M. Ideal timing of surgical repair of isolated complete atrioventricular septal defect. Interact Cardiovasc Thorac Surg.2007; 6: 24-26. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17669760
  3. Xie O, Brizard CP, d’Udekem Y, Galati JC, Kelly A , et al. Outcomes of repair of complete atrioventricular septal defect in the current era. Eur J Cardiothorac Surg. 2014; 45: 610-617. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24057432
  4. Tumanyan MR, Filaretova OV, Chechneva VV, Gulasaryan RS, Butrim IV, et al. Repair of complete atrioventricular septal defect in infants with down syndrome: outcomes and long-term results. Pediatr Cardiol. 2015; 36: 71-75. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25099029
  5. Frontera-Izquierdo P, Cabezuelo-Huerta G. Natural and modified history of complete atrioventricular septal defect--a 17 year study. Arch Dis Child. 1990; 65: 964-967. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/2221969
  6. Jeong IS, Lee CH, Lee C, Lim HG, Kim IS, et al. Surgical outcomes of the modified single-patch technique in complete atrioventricular septal defect. Interact Cardiovasc Thorac Surg. 2009; 8: 435-438. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19181697
  7. Okada Y, Tatsuno K, Kikuchi T, Takahashi Y, Shimokawa T. Complete atrioventricular septal defect associated with tetralogy of fallot: surgical indications and results. Jpn Circ J. 1999; 63: 889-892. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/10598897
  8. Murashita T, Hatta E, Kubota T, Imamura M, Shiiya N, et al. Simplified technique for patch augmentation and chorda reconstruction of left atrioventricular valve in complete atrioventricular septal defect. J Card Surg. 2003; 18: 253-256. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12809400
  9. Gatzoulis MA, Shore D, Yacoub M, Shinebourne EA. Complete atrioventricular septal defect with tetralogy of Fallot: diagnosis and management. Br Heart J. 1994; 71: 579-583. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1025458/