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Outcomes after repair of complete atrioventricular canal with a modified single-patch technique: a retrospective
George Samanidis1,2, Konstantinos Kostopanagiotou3, Meletios Kanakis2
1Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece.
Insights
The single-patch technique for complete atrioventricular canal defect (CAVC) repair is safe and effective, showing good short- and midterm outcomes. This method is associated with low mortality and acceptable valve function in pediatric patients.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Surgery
- Medical Devices
Background:
- Complete atrioventricular canal defect (CAVC) is a complex congenital heart anomaly.
- Surgical repair is the standard treatment for CAVC.
- The single-patch technique is one approach for CAVC repair.
Purpose of the Study:
- To evaluate the short- and midterm outcomes of complete atrioventricular canal defect (CAVC) repair using a single-patch technique.
- To assess the safety and efficacy of this surgical method in pediatric patients.
Main Methods:
- Retrospective study of 30 children who underwent CAVC repair with a single-patch technique.
- Analysis of in-hospital and follow-up data, including mortality, valve function, and reoperations.
- Statistical analysis to identify risk factors for adverse outcomes.
Main Results:
- Zero in-hospital mortality and no deaths during a median 4-year follow-up.
- Late moderate mitral regurgitation (MR) was observed in 96.6% (2 years) and 50% (5 years) of patients.
- Absence of Down syndrome was identified as a risk factor for late moderate MR (p=0.01).
- One patient required reoperation for left ventricular outflow tract obstruction.
Conclusions:
- The single-patch technique for CAVC repair demonstrates a safe profile.
- This method yields acceptable short- and midterm results in pediatric populations.
- Further monitoring for valve regurgitation, particularly in patients without Down syndrome, is warranted.
Background:
This study aimed to present the short- and midterm outcomes after complete atrioventricular canal defect (CAVC) repair using a single-patch technique.
Methods:
This study included 30 children who underwent surgical correction of the CAVC using a single-patch technique.
Results:
The median age of the patients was 5.7 months (interquartile range [IQR], 5.0-7.5 months), and 23 patients (76.7%) had type A CAVC. Fourteen patients (46.7%) were female and 17 (56.7%) had been diagnosed with Down syndrome. The in-hospital mortality rate was 0%. No deaths were observed during a median follow-up of 4 years (IQR, 3.5-5.0 years). Patients without Down syndrome were associated with late moderate mitral regurgitation (MR) (p=0.02). Late MR less than moderate degree was observed in 96.6%, 78.5%, and 50% of patients after 2, 4, and 5 years of follow-up, respectively, while late tricuspid valve regurgitation less than moderate degree was observed in 96.7%, 85.9%, and 59.0% of patients after 2, 4, and 6 years of follow-up, respectively. After a median follow-up of 4 years, only one patient had required surgical repair of a left ventricular outflow tract obstruction, which occurred 26 months after the first operation. Multivariable logistic regression analysis adjusted for the type of CAVC, sex, Down syndrome, age, and weight revealed that the absence of Down syndrome was a risk factor for late moderate MR (MR-2) (odds ratio, 0.05; 95% confidence interval, 0.006-0.50; p=0.01).
Conclusion:
A single-patch technique for CAVC surgical repair is a safe method with acceptable short- and midterm results.
