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Atrioventricular canal: modified single patch technique.

Graham R Nunn¹

¹The Children's Hospital at Westmead, Westmead, NSW, Sydney, Australia. gnunn@tpg.com.au

Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual

|April 17, 2007

Summary

A modified single patch technique for complete atrioventricular canal repair shows promising results. This approach in 128 patients had low mortality and minimal long-term complications, including no significant residual defects or left ventricular outlet obstruction.

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Area of Science:

Cardiology
Pediatric Cardiac Surgery
Congenital Heart Disease

Background:

Complete atrioventricular canal (CAVC) is a complex congenital heart defect.
Surgical repair techniques aim to minimize residual defects and ensure good long-term outcomes.
Previous methods include single-patch and two-patch repairs, each with specific advantages and challenges.

Purpose of the Study:

To evaluate the outcomes of a modified single-patch technique for CAVC repair.
To assess short-term mortality and long-term complications.
To compare results with historical data from two-patch CAVC repair and partial atrioventricular canal repair.

Main Methods:

Retrospective review of 128 patients undergoing CAVC repair by a single surgeon using a modified single-patch technique.

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Analysis of 30-day mortality.

Long-term follow-up to assess residual defects, need for mitral valve reoperation, and left ventricular outlet obstruction (LVOTO).

Comparison with author's prior experience with two-patch CAVC repair (46 cases) and partial atrioventricular canal repair (126 cases).

Main Results:

Thirty-day mortality was 1.6%.
No significant residual ventricular septal defects were observed.
Mitral valve reoperation was required in 2.3% of patients.
No instances of LVOTO requiring resection occurred during the follow-up period.

Conclusions:

The modified single-patch technique for CAVC repair is associated with favorable early and late outcomes.
This technique appears to reduce the incidence of significant residual defects and LVOTO.
Further comparison with other techniques supports the efficacy of this modified approach for CAVC management.