Complete atrioventricular septal defect: comparison of modified single-patch technique with two-patch technique in...

Area of Science:

• Pediatric Cardiac Surgery
• Congenital Heart Defects
• Surgical Techniques

Background:

• Complete atrioventricular septal defects (AVSD) are complex congenital heart abnormalities.
• Surgical repair is essential for managing complete AVSD in infants.
• Comparing different surgical techniques is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the modified single-patch technique with the traditional two-patch technique for complete AVSD repair in infants.
• To evaluate the safety, efficacy, and long-term results of both surgical approaches.

Main Methods:

• A retrospective study of 98 infants undergoing complete AVSD primary repair between 2001 and 2011.
• Comparison of outcomes between 46 infants who received the modified single-patch technique and 59 who received the two-patch technique.
• Echocardiographic follow-up in 87 patients to assess atrioventricular (AV) valve regurgitation.

Main Results:

• The modified single-patch group had significantly shorter cross-clamp (70.56 ± 21.05 min) and cardiopulmonary bypass times (95.02 ± 19.73 min) compared to the two-patch group (83.76 ± 22.74 min and 109.9 ± 34.07 min, respectively).
• No third-degree atrioventricular (AV) block occurred in the single-patch group, versus two patients requiring pacemakers in the two-patch group (p=NS).
• Reoperation rates and rates of more than moderate left AV valve regurgitation were similar between the groups (p=0.841 and p=0.886, respectively).

Conclusions:

• The modified single-patch technique is a safe and reproducible surgical option for complete AVSD in infants.
• Outcomes are comparable to the two-patch technique, with potential benefits of shorter operative times and reduced AV block incidence.
• Long-term survivors demonstrate good clinical and functional results with minimal AV valve regurgitation.