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The double patch repair for complete atrioventricularis communis
S Bert Litwin1, James S Tweddell, Michael E Mitchell
1Department of Cardiothoracic Surgery, Herma Heart Center, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA. sblitwin@chw.org
Insights
The two-patch repair for complete atrioventricularis communis is a reliable surgical method. This technique demonstrates low mortality and minimal need for reoperation in pediatric patients.
Area of Science:
- Congenital Heart Surgery
- Pediatric Cardiology
- Cardiac Surgery Techniques
Background:
- Complete atrioventricularis communis (CAVC) is a complex congenital heart defect.
- Surgical repair of CAVC presents significant challenges in pediatric patients.
- The two-patch repair technique has been utilized for CAVC correction.
Purpose of the Study:
- To review the outcomes of the two-patch repair for CAVC.
- To assess the efficacy and safety of this surgical approach in infants and children.
- To evaluate long-term results, including mortality and reoperation rates.
Main Methods:
- Retrospective review of surgical cases.
- Analysis of patient data from October 1988 to December 2005.
- Evaluation of mortality, morbidity, and reoperation rates following two-patch repair for CAVC.
Main Results:
- 222 infants and children underwent the two-patch repair for CAVC.
- Low overall mortality with 6 early (2.7%) and 6 late (2.7%) deaths.
- 10% of patients required reoperation for various complications, with no need for mitral valve replacement.
Conclusions:
- The two-patch repair is a reliable and effective surgical technique for complete atrioventricularis communis.
- This method is associated with low mortality and a low incidence of reoperation.
- The technique provides durable results in the pediatric population, avoiding late mitral valve replacement.
Abstract:
This article is a review of our experience with the two-patch repair of complete atrioventricularis communis. From October 1988 through December 2005, 222 infants and children underwent surgery. There were six early (2.7%) and six late (2.7%) deaths. Reoperation was required in 22 patients (10%) for residual or recurrent mitral regurgitation or stenosis, subaortic stenosis, repair of a ventricular septal defect with or without pulmonary stenosis, placement of a right heart valved conduit, and/or placement of a permanent cardiac pacemaker. All patients survived second operations and no child required early or late mitral valve replacement. The two-patch repair is a reliable surgical technique resulting in low mortality and a low need for reoperation.
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