Related Experiment Videos
Repair of atrioventricular septal defects in infancy
Insights
Surgical repair of complete atrioventricular septal defects in infants is safe and effective. Ventricular distention is a key technique for successful mitral valve repair in these pediatric cardiac patients.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease Surgery
- Cardiac Surgery
Background:
- Complete atrioventricular septal defects (CAVSD) are complex congenital heart abnormalities.
- Infants with CAVSD often present with pulmonary artery hypertension, congestive heart failure, and failure to thrive.
- Mitral insufficiency is a common preoperative comorbidity in infants with CAVSD.
Purpose of the Study:
- To evaluate the safety and efficacy of surgical repair for complete atrioventricular septal defects in infants.
- To highlight the role of ventricular distention in achieving successful mitral valve repair during CAVSD surgery.
Main Methods:
- Retrospective analysis of 15 infants (<12 months) undergoing CAVSD repair between 1981-1984.
- Surgical technique involved utilizing ventricular distention to guide valve repair and assess competency.
- Data collected included patient demographics, preoperative conditions, operative details, and outcomes.
Main Results:
- No operative mortality; two late deaths occurred in the cohort of 15 infants.
- Average age at operation was 8.5 months, average weight 5.7 kg.
- All infants had pulmonary artery hypertension; 53% had preoperative mitral insufficiency.
Conclusions:
- Surgical repair of complete atrioventricular septal defects in infants is a safe procedure with acceptable outcomes.
- Ventricular distention is a critical intraoperative technique for ensuring accurate valve repair and assessing competency.
- This approach facilitates successful surgical management of CAVSD in the pediatric population.
Abstract:
Fifteen infants less than 12 months of age with complete atrioventricular septal defects underwent repair of the defect between January, 1981, and December, 1984. The average age at operation was 8 1/2 months and the average weight was 5.7 kg. Eight of 15 (53%) infants had preoperative mild to moderate mitral insufficiency. Pulmonary artery hypertension was present in all infants and 13 of 15 infants had a pulmonary arterial resistance greater than 4 units (mean 8.8 units). Operative indication was based on pulmonary artery hypertension, congestive heart failure, and failure to thrive. Ventricular distention was utilized during operative repair to assess location of valve incision, level of attachment of valves to the patch, and cleft approximation. It was also used to check the competency of the mitral repair once complete. The average circulatory arrest time was 55.7 minutes. There were no operative deaths. There were two late deaths. We conclude that ventricular distention is the key to the operation, and operative repair is safe in infants with atrioventricular septal defects.