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Published on: July 18, 2014
Surgical treatment of atrioventricular canal defect
Insights
Surgical repair of congenital atrioventricular canal defects shows promising outcomes. While some mortality exists, survivors of partial defects experienced good long-term results, with no persistent atrioventricular blocks.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Defects
Background:
- Congenital anomalies of the atrioventricular canal are complex heart defects requiring surgical intervention.
- Partial and complete atrioventricular canal defects present distinct anatomical and clinical challenges.
Purpose of the Study:
- To evaluate the surgical outcomes and long-term follow-up of patients with congenital atrioventricular canal defects.
- To assess the efficacy of surgical repair in managing partial and complete atrioventricular canal defects.
Main Methods:
- Retrospective analysis of 59 patients undergoing surgical repair for atrioventricular canal defects.
- Follow-up of all survivors to assess long-term clinical status, including reoperations and complications.
Main Results:
- In 42 patients with partial defects, 7.1% mortality was observed due to specific complications; however, survivors showed good outcomes with no persistent atrioventricular blocks.
- Reoperations in five patients with partial defects were successful, and most patients remained asymptomatic.
- Of 17 patients with complete defects, six died postoperatively; no pacemakers were required, but two had persistent cardiomegaly.
Conclusions:
- Surgical repair of congenital atrioventricular canal defects, particularly partial defects, can lead to favorable long-term outcomes.
- Complete atrioventricular canal defects present higher surgical risks and potential for persistent complications.
- Continued monitoring is essential for patients with congenital atrioventricular canal defects post-surgery.
Abstract:
Fifty-nine patients with congenital anomalies of the atrioventricular canal underwent operation and all survivors were followed up. In 42 patients with partial atrioventricular canal defects, ten had preoperative congestive heart failure. Three, or 7.1%, died of endomyocardial fibroelastosis, high pulmonary vascular resistance, and severe mitral regurgitation. A fourth patient later died of Wolff-Parkinson-White syndrome and fibrilation. Reoperations in five patients were all successful. No patients had persistent atrioventricular blocks, and all patients are asymptomatic. Two of these subjects continue to receive digoxin therapy, and one of them is believed to have substantial mitral insufficiency. Of the 17 patients who had complete atrioventricular canal defects, 13 had a divided common anterior leaflet attached to the septum by chordae tendineae, and four had undivided and unattached anterior leaflets. Two had previously undergone pulmonary banding, and nine were treated for congestive heart failure. Six died after operation. There were no reoperations. No patient presently has required a pacemaker. Two subjects have persistent cardiomegaly.
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