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Modified single-patch compared with two-patch repair of complete atrioventricular septal defect.

Shinya Ugaki1, Nee S Khoo1, David B Ross1

  • 1Division of Pediatric Cardiac Surgery, Cardiology and Critical Care, Stollery Children's Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.

The Annals of Thoracic Surgery
|November 26, 2013
PubMed
Summary

Modified single-patch repair for complete atrioventricular septal defect (CAVSD) offers shorter surgical times. Outcomes regarding left ventricular outflow tract (LVOT) diameter and left atrioventricular valve (LAVV) coaptation were similar between single-patch and two-patch repairs.

Keywords:
21

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Area of Science:

  • Cardiology
  • Pediatric Cardiac Surgery
  • Congenital Heart Disease

Background:

  • Complete atrioventricular septal defect (CAVSD) is a complex congenital heart anomaly.
  • Surgical repair techniques aim to optimize outcomes and minimize complications.
  • Modified single-patch and two-patch repairs are common surgical approaches for CAVSD.

Purpose of the Study:

  • To compare the efficacy of modified single-patch versus two-patch repair for CAVSD.
  • To evaluate the impact of each repair technique on left ventricular outflow tract (LVOT) diameter.
  • To assess the effect of each repair technique on left atrioventricular valve (LAVV) coaptation.

Main Methods:

  • Retrospective review of 2-dimensional echocardiograms from CAVSD patients (2005-2011).
  • Measurement of LAVV leaflet coaptation length and LVOT diameter.
  • Comparison of outcomes between modified single-patch (n=29) and two-patch (n=22) repair groups.

Main Results:

  • Modified single-patch repair demonstrated significantly shorter bypass (102.0±33.6 vs 152.9±39.5 min) and ischemic times (69.0±21.7 vs 106.9±29.7 min).
  • No significant differences were observed in indexed LAVV coaptation length (p=0.25/0.21) or indexed LVOT diameter (p=0.22) between the groups.
  • No hospital or late deaths occurred; reoperation rates were comparable (5 vs 1 patient).

Conclusions:

  • Modified single-patch repair is associated with reduced bypass and ischemic times.
  • Postoperative LVOT diameter and LAVV coaptation are not significantly different between the two surgical techniques.
  • Both repair methods offer comparable long-term safety profiles for CAVSD treatment.