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Complete atrioventricular canal: comparison of modified single-patch technique with two-patch technique.

Carl L Backer¹, Robert D Stewart, Frédérique Bailliard

¹Division of Cardiovascular Thoracic Surgery, and Cardiology, Children's Memorial Hospital, Chicago, IL 60614, USA. cbacker@childrensmemorial.org

The Annals of Thoracic Surgery

|November 27, 2007

Summary

The modified single-patch technique offers comparable outcomes to the two-patch technique for complete atrioventricular canal (CAVC) defects. This approach also significantly reduces cross-clamp and cardiopulmonary bypass times in infants.

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Area of Science:

Pediatric Cardiac Surgery
Congenital Heart Defects
Surgical Techniques

Background:

Complete atrioventricular canal (CAVC) defects are complex congenital heart conditions.
Surgical repair is essential for managing CAVC defects in infants.
Two surgical techniques, the modified single-patch and the two-patch method, are commonly employed.

Purpose of the Study:

To compare the efficacy and outcomes of the modified single-patch technique versus the two-patch technique for CAVC repair in infants.
To evaluate differences in operative times, complication rates, and long-term results between the two surgical approaches.

Main Methods:

A retrospective study of 55 infants undergoing CAVC repair between 2000 and 2006.
Patients were divided into two groups: 26 receiving the modified single-patch technique and 29 receiving the two-patch technique.
Demographic data, operative details, and postoperative outcomes were analyzed, including Rastelli classification and valve insufficiency.

Main Results:

The modified single-patch group experienced shorter cross-clamp (97.3 vs 123.3 min) and cardiopulmonary bypass times (128 vs 157 min).
No significant differences were observed in mortality, reoperation rates for mitral insufficiency or residual VSD, or AV valve insufficiency.
Fewer patients in the single-patch group required pacemakers for AV block compared to the two-patch group.

Conclusions:

The modified single-patch technique provides comparable results to the two-patch technique for CAVC repair in infants.
This technique is associated with significantly reduced operative times, potentially leading to improved patient recovery.
Both techniques demonstrate acceptable outcomes regarding valve function and need for reoperation.