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[Experiences with surgical treatment of the complete form of atrioventricular septum defect]
1II. Chirurgische Universitätsklinik, Wien.
Insights
Surgical correction for complete atrioventricular septal defect in 13 children showed promising results. Most patients achieved good outcomes, with no complete atrioventricular block observed post-surgery.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease Surgery
- Cardiac Anatomy
Context:
- Complete atrioventricular septal defect (CAVSD) is a complex congenital heart condition.
- Surgical correction is the standard treatment for symptomatic CAVSD in infants and children.
- Rastelli classification categorizes different anatomical variations of CAVSD, influencing surgical strategy.
Purpose:
- To evaluate the surgical outcomes of complete atrioventricular septal defect correction using a specific patching technique.
- To assess the efficacy and safety of approximating valve leaflets without incision in pediatric CAVSD repair.
- To analyze early postoperative complications and long-term results in a cohort of young children.
Summary:
- Thirteen children (3-30 months) with CAVSD underwent surgical repair.
- A single patch was used for Rastelli Type A and two patches for Type C, preserving AV valve tissue.
- Left superior and inferior valve leaflets were approximated with sutures; one mortality, 7 good results, 5 requiring medical management.
Impact:
- This surgical approach demonstrates feasibility in pediatric CAVSD repair.
- The technique may reduce the risk of atrioventricular valve dysfunction and complete heart block.
- Further studies are warranted to confirm long-term benefits and compare with alternative surgical methods.
Abstract:
13 children whose ages ranged from 3 to 30 months, with complete atrioventricular septal defect underwent surgical correction. 1 patch was used in Rastelli Type A cases and 2 patches in Rastelli Type C patients, without incision of the AV valve tissue. In all cases the left superior and inferior valve leaves were approximated with 2 or 3 stitches. One child died postoperatively. A good result was attained in 7 children. 5 children still need digitalis and diuretics. Complete AV-block was not seen.