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Use of a prosthesis for repair of complete common atrioventricular canal
Insights
This study explored using pericardium patches to repair common atrioventricular canal (Rastelli C-type) in children. The surgical technique effectively controlled valvular regurgitation in most patients, showing promising long-term results.
Area of Science:
- Cardiology
- Pediatric Cardiac Surgery
- Congenital Heart Disease
Background:
- Common atrioventricular canal (Rastelli C-type) is a complex congenital heart defect requiring surgical intervention.
- Managing valvular regurgitation in these patients presents a significant surgical challenge.
Observation:
- Five pediatric patients with common atrioventricular canal underwent surgery between 1977 and 1979.
- The surgical technique involved extending mitral and tricuspid valve leaflets using autologous pericardium patches to address regurgitation.
Findings:
- Postoperative follow-up in 4 of 5 patients (followed for 2.7 to 5.3 years) demonstrated favorable clinical courses.
- Minimal residual valvular regurgitation was observed in all successfully treated cases.
- One patient experienced a postoperative death due to unrelated intracranial bleeding.
Implications:
- Autologous pericardium patching appears to be an effective method for controlling regurgitation in common atrioventricular canal.
- Long-term durability of the pericardium patch requires continued monitoring.
- This surgical approach offers a viable option for improving outcomes in pediatric patients with this condition.
Abstract:
From April, 1977 to November, 1979, 5 cases with common atrioventricular canal (Rastelli C-type) underwent surgery, in which the leaflets of both the mitral and tricuspid valves were extended using an auto-pericardium patch in order to control regurgitation. Their ages ranged from one year 3 months to 6 years (mean, 3 years 7 months). One case died on the 37th postoperative day from intracranial bleeding unrelated to the cardiac procedure. In the remaining 4 cases, postoperative examination showed an improvement, and their clinical courses which were followed from 2 years 7 months to 5 years 3 months, were favourable, with only minimal valvular regurgitation remaining in all cases. Although the fate of the pericardium patch must be followed over a long period, this procedure appears to be effective for control of regurgitation in this disease.