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Retrospective study of complete atrioventricular canal defects: Anesthetic and perioperative challenges

Aniruddha Ramesh Janai1, Wilfried Bellinghausen1, Edwin Turton1

  • 1Department of Anesthesiology and Intensive Care Medicine, Heart Center Leipzig, Leipzig, Germany.

Annals of Cardiac Anaesthesia
|January 17, 2018
PubMed

Insights

Protocolized care for infants with complete atrioventricular canal defects significantly improves surgical outcomes. This approach ensures excellent results in biventricular repair surgery for these complex congenital heart conditions.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Surgery
  • Anesthesiology

Background:

  • Complete atrioventricular (AV) canal defects are complex congenital heart conditions requiring specialized surgical intervention.
  • Infants with these defects often have associated comorbidities, such as Down syndrome, necessitating careful perioperative management.

Purpose of the Study:

  • To evaluate the anesthetic and perioperative management strategies employed in infants undergoing surgical repair of complete atrioventricular canal defects.
  • To assess the outcomes associated with a protocolized approach to biventricular repair in this patient population.

Main Methods:

  • A retrospective descriptive study of 157 infants who underwent primary or staged biventricular repair for complete AV canal defects between 1999 and 2013.
  • Data collected included demographic information, anesthetic management, cardiopulmonary bypass details, and intensive care unit (ICU) outcomes.

Main Results:

  • A standardized protocol for anesthesia, cardiopulmonary bypass, and ICU care was consistently applied.
  • Key outcomes included a 0% in-hospital mortality rate, a mean hospital stay of 14.5 days, and low rates of complications such as reoperation (3.8%) and permanent pacemaker implantation (2.5%).
  • Pulmonary hypertension was present in 60% of patients, with 30% requiring nitric oxide therapy.

Conclusions:

  • A protocolized perioperative management strategy is associated with excellent outcomes in infants undergoing surgical repair of complete atrioventricular canal defects.
  • This standardized approach contributes to successful biventricular repair and improved patient survival.
Abstract

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