TWELVE YEARS OF COMPLETE ATRIOVENTRICULAR SEPTAL DEFECT REPAIR

Authors

  • André Sena Department of Cardiothoracic surgery, Hospital de Santa Maria, Lisbon, Portugal
  • Ventsislav Sheytanov Sana Cardiac Surgery Stuttgart GmbH, Stuttgart, Germany
  • Markus Liebrich Sana Cardiac Surgery Stuttgart GmbH, Stuttgart, Germany
  • Anita Narr Sana Cardiac Surgery Stuttgart GmbH, Stuttgart, Germany
  • Ulrich Schweigmann Department of Pediatric Cardiology/Pulmonology and Intensive Care Medicine, Olgahospital, Stuttgart, Germany.
  • Frank Uhlemann Department of Pediatric Cardiology/Pulmonology and Intensive Care Medicine, Olgahospital, Stuttgart, Germany.
  • Nicolas Doll Sana Cardiac Surgery Stuttgart GmbH, Stuttgart, Germany
  • Ioannis Tzanavaros Sana Cardiac Surgery Stuttgart GmbH, Stuttgart, Germany

DOI:

https://doi.org/10.48729/pjctvs.101

Abstract

Background: Surgical repair is the standard treatment for complete atrioventricular septal defect. At our institution, this repair is performed by single patch, modified single patch or two patch techniques, according to the surgeon preferences and the surgical anatomy of the defect. The goal of this study was to evaluate our results from the last twelve years.

Methods: From June 2006 to June 2018, 81 children with complete atrioventricular septal defect (without tetralogy of Fallot or unbalanced ventricles) were submitted to surgical repair at our institution. Data from all patients was retrospectively collected and evaluated.

Results: The average age was 6.9 ± 13.7 months and 84% had Down syndrome. Eighty percent were symptomatic and 6 patients were previously submitted to pulmonary artery banding. No more that mild left atrioventricular valve insufficiency was found in 84% and 89% of the patients, at discharge and follow-up, respectively. Small residual septal defects were present in 27% at discharge; during follow-up, 41% of these closed spontaneously. Pulmonary hypertension at discharge and follow-up appeared in 3.7% and 1.3%, respectively. Permanente pacemaker was implanted in 3 patients. Left ventricle outflow tract obstruction was found in 3 patients and 2 needed surgical correction. At follow-up (40 ± 38 months), 90% of the patients presented NYHA functional class I. No significant differences in the main repair outcomes were found between techniques, with the exception of small residual septal defects, although the groups were unmatched.

Conclusions: Overall and regardless of the technique used for the repair of complete AVSD, good early and midterm outcomes were achieved.

Downloads

Download data is not yet available.

References

Jacobs JP, Burke RP, Quintessenza JA, Mavroudis C. Congenital Heart Surgery Nomenclature and Database Project: Atrioventricular canal defect. Ann Thorac Surg 2000; 69:S36-S43.

Marino B. Congenital heart disease in patients with Down’s syndrome: Anatomic and genetic aspects. Biomed Pharmacother 1993; 47:197-200.

Karl TR, Provenzano SC, Nunn GR, Anderson RH. The current surgical perspective to repair of atrioventricular septal defect

with common atrioventricular junction. Cardiol Young 2010; 20(3):120-7.

Rastelli GC, Ongley PA, McGoon DC. Surgical repair of complete atrio-ventricular canal with anterior common leaflet

undivided and unattached to ventricular septum. Mayo Clin Proc 1969; 44:335-341.

Sabine H, Daebritz, MD. Correction of Complete Atrioventricular Septal Defects With Two Patch Technique. Oper Tech

Thorac Cardiovasc Surg 2004; 9:208-220.

Geoffrion TR, Singappuli K, Murala JSK. A review of the Nunn modified single patch technique for atrioventricular septal

defect repair. Transl Pediatr. 2018; 7(2):91-103.

Pan G1, Song L, Zhou X, Zhao J. Complete atrioventricular septal defect: comparison of modified single-patch technique

with two-patch technique in infants. J Card Surg 2014; 29(2):251-5.

Li D, Fan Q, Iwase T, Hirata Y, An Q. Modified Single-Patch Technique Versus Two-Patch Technique for the Repair of

Complete Atrioventricular Septal Defect: A Meta-Analysis. Pediatr Cardiol 2017; 38(7):1456-1464.

Xiong Y, Wang L, Liu W, Hankey GJ, Xu B, Wang S. The Prognostic Significance of Right Bundle Branch Block: A Meta-

-analysis of Prospective Cohort Studies. Clin Cardiol 2015; 38(10):604-13.

Harkness WT, Hicks M. Rhythm, Bundle Branch Block, Right (RBBB). StatPearls [Internet] 2018.

Harmandar B1, Aydemir NA, Karaci AR, Sasmazel A, Saritas T, Bilal MS, Yekeler I. Results for surgical correction of complete atrioventricular septal defect: associations with age, surgical era, and technique. J Card Surg. 2012 Nov;27(6):745-53.

Deraz S, Ismail M. Single patch technique versus double patch technique in repair of complete atrioventricular septal

defect. The Egyptian Heart Journal 2013. 66(2): 177-182.

Sivalingam S, Krishnasamy S, Al-Fahmi NA et al. Early and midterm outcome of complete atrioventricular septal defect

(AVSD) in a single institution. Indian J Thorac Cardiovasc Surg 2013. 29:223–229.

Atz AM, Hawkins JA, Lu M et al. Surgical management of complete atrioventricular septal defect: associations with surgical technique, age, and trisomy 21. J Thorac Cardiovasc Surg 2011. 141:1371–1379.

Pan G, Song L, Zhou X et al. Complete atrioventricular septal defect: comparison of modified single-patch technique with

two-patch technique in infants. J Card Surg 2014. 29:251–255.

Downloads

Published

30-04-2021

How to Cite

1.
Sena A, Sheytanov V, Liebrich M, Narr A, Schweigmann U, Uhlemann F, Doll N, Tzanavaros I. TWELVE YEARS OF COMPLETE ATRIOVENTRICULAR SEPTAL DEFECT REPAIR. Rev Port Cir Cardiotorac Vasc [Internet]. 2021 Apr. 30 [cited 2024 Nov. 21];26(3):187-93. Available from: https://pjctvs.com/index.php/journal/article/view/101

Issue

Section

Original Articles

Most read articles by the same author(s)