[Reoperation after surgical repair of atrioventricular canal defect]

Among 114 survivors who underwent total repair of atrioventricular canal defect between 1981 and 1993, 19 patients underwent reoperation for the occurrence and progression of mitral valve insufficiency (18 patients), thrombosed prosthetic valve (1 patient), and subaortic stenosis (4 patients) on one or two occasions after operation. There were 7 males and 12 females with ages at reoperation ranging from 3 months to 13.8 years (mean, 3.8 years), and was no operative but one late death. At reoperation, reparative procedures involving the readjustment of previously repaired mitral cleft and annuloplasty were successfully achieved in 6 patients who had no additional abnormalities of subvalvar apparatus. Twelve patients, who were associated with additional valvar and subvalvar lesions, needed a prosthetic valve replacement. We emphasized that surgical technique based on precise knowledge of each individual mitral and submitral anatomy is indispensable to achieve good surgical results. When the anatomy involves submitral abnormalities, careful postoperative follow-up should be recommended to take measures of the progression of mitral valve regurgitation.