The V-shaped double-layer patch technique for complete atrioventricular septal defect: A novel surgical technique

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Congenital Heart Defects

Background:

• Complete atrioventricular septal defects (CAVSD) often require surgical intervention.
• Existing surgical techniques for CAVSD repair may lead to postoperative complications and reoperations.
• A need exists for improved surgical methods to minimize reoperation rates and enhance long-term outcomes.

Purpose of the Study:

• To evaluate the efficacy of a modified V-shaped double-layer patch technique for CAVSD repair.
• To assess the postoperative anatomical advantages and reoperation rates associated with this modified technique.
• To share surgical experience and contribute to the understanding of optimal CAVSD management.

Main Methods:

• Retrospective analysis of 29 patients undergoing CAVSD repair with a V-shaped double-layer patch.
• Surgical procedures performed between April 2011 and September 2019.
• Evaluation of postoperative outcomes including reoperations, valve function, and anatomical results via echocardiography.

Main Results:

• No deaths occurred; only one reoperation (3.4%) was required.
• Mean aortic crossclamp and cardiopulmonary bypass times were 62.7 ± 16.0 and 113.9 ± 25.9 minutes, respectively.
• Median follow-up was 5.1 years, with no significant residual defects or left ventricular outflow tract obstruction; favorable left atrioventricular valve function was observed.

Conclusions:

• The V-shaped double-layer patch technique is a valuable surgical option for CAVSD repair.
• This technique demonstrates excellent midterm performance, potentially reducing reoperation needs.
• Augmenting the anterior left atrioventricular valve area may lead to outcomes closer to a normal mitral valve.