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Atrioventricular canal defect: two-patch repair and tricuspidization of the mitral valve

M H Ashraf1, Z Amin, R Sharma

  • 1Department of Cardiovascular Surgery, Miami Children's Hospital, Florida 33155.

The Annals of Thoracic Surgery
|February 1, 1993
PubMed

Insights

This study shows that a two-patch repair with tricuspidization effectively treats complete atrioventricular canal defects, offering durable mitral valve repair and good long-term survival.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Complete atrioventricular canal defect (CAVC) is a complex congenital heart anomaly.
  • Surgical repair aims to restore normal cardiac anatomy and function.
  • The atrioventricular valve is a critical component requiring precise surgical management.

Purpose of the Study:

  • To evaluate the long-term outcomes of a specific surgical technique for complete atrioventricular canal defect.
  • To assess the efficacy of two-patch repair with tricuspidization of the left atrioventricular valve.
  • To determine survival rates, reoperation rates, and functional status post-repair.

Main Methods:

  • Retrospective analysis of 104 patients undergoing two-patch repair with tricuspidization.
  • Patients included those with primary repair (n=68) and prior pulmonary artery banding (n=36).
  • Follow-up included clinical assessment, echocardiography, and survival data up to 13 years.

Main Results:

  • Actuarial survival at 13 years was 81%, with 92% event-free survival.
  • 86% of patients were in sinus rhythm postoperatively; only one required a permanent pacemaker.
  • Postoperative echocardiograms showed minimal or no mitral regurgitation, indicating durable valve repair.

Conclusions:

  • Two-patch repair with tricuspidization is a safe and effective surgical strategy for complete atrioventricular canal defect.
  • This technique preserves valve integrity, leads to durable mitral valve repair, and has low rates of reoperation and heart block.
  • The approach demonstrates excellent long-term functional outcomes and survival, even in younger patients.

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