Skip to main content
Log in

Complete atrioventricular septal defect repair: Simplified single patch technique

  • Original Articles
  • Published:
Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Background: There has been a rekindling of interest in alternatives to conventional two patch technique for the repair of complete atrioventricular septal defect in infancy in the recent past. We applied the simplified single patch technique to 15 consecutive infants and herein report our intermediate term results.

Methods: Between March 1998 and September 2001, fifteen patients underwent repair of complete atrioventricular septal defect with this technique (mean age 6 months, mean weight 5.4 kg). Downs syndrome was present in 11 patients. Repair was done in all patients by direct suturing of the common atrioventricular valve leaflets to the crest of the ventricular septum irrespective of the size of the ventricular septal component. The cleft in the anterior mitral leaflet was closed in all patients. The atrial septal component was closed by a pericardial patch.

Results: There was no mortality. There were no pulmonary arterial hypertensive crises or heart block. The mean follow up was 13.2 months. One patient underwent mitral valve replacement after one year due to severe mitral regurgitation. The remaining fourteen patients had no significant mitral regurgitation, residual ventricular septal defect or left ventricular outflow tract obstruction on echocardiography.

Conclusion: Simplified single patch technique is an easily reproducible method for surgical repair of complete atrioventricular septal defect. It is less time consuming and minimises ischaemic time. Atrioventricular valve function is preserved and there is no incidence of obstruction to left ventricular outflow tract. The intermediate term results are encouraging.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Lillehei CW, Cohen M, Warden HE, Varco RL. The direct vision intra-cardiac correction of congenital anomalies by controlled cross circulation: results in thirty two patients with ventricular septal defects, tetralogy of fallot and atrioventricular comminis defects. Surgery 1955; 38: 11–29.

    PubMed  CAS  Google Scholar 

  2. Rastelli GC, Ongley PA, Kirklin JW, Mc Goon DC. Surgical repair of complete form of persistent common atrio-ventricular canal. J Thorac Cardiovasc Surg 1968; 55: 299–308.

    PubMed  CAS  Google Scholar 

  3. Trusler GA Correction of types Complete atrioventricular canal: surgical considerations J Thorac Cardiovasc Surg 1971; 71: 27.

    Google Scholar 

  4. Backer CL, Mavroudis C, Alboliras ET, Zales VR. Repair of complete atrioventricular canal defects: results with the two-patch technique. Ann Thorac Surg 1995; 60: 530–37.

    Article  PubMed  CAS  Google Scholar 

  5. Alexi-Meskishvili V, Ishino K, Dahnert I, Uhlemann F, Weng Y, Lange PE, Hetzer R. Correction of complete atrio-ventricular septal defects with the double patch technique and cleft closure. Ann Thorac Surg 1996; 62: 519–25.

    Article  PubMed  CAS  Google Scholar 

  6. Crawford FA and Stroud MR. Surgical repair of complete atrio-ventricular septal defect. Ann. Thorac Surg. 2001; 72: 1621–29.

    Article  PubMed  Google Scholar 

  7. Wilcox BR, Jones DR, Frantz EG, et al. Anatomically sound simplified approach to repair of “complete” atrio-ventricular septal defect. Ann Thorac Surg 1997; 64: 487–94.

    Article  PubMed  CAS  Google Scholar 

  8. Nicholson IA, Nunn GR, Sholler GF, Hawker RE, Cooper SG, Lau KC and Cohn LH. Simplified single patch technique for the repair of atrio-ventricular septal defect. J Thorac Cardio vasc Surg 1999; 118: 642–47.

    Article  CAS  Google Scholar 

  9. Hanley FL, Fenton KN, Jonas RA, Mayer JE, Cook NR, Wernovsky G and Castaneda AR. Surgical repair of complete atrioventricular canal defects in infancy. J Thorac Cardiovasc Surg 1993; 106: 387–97.

    PubMed  CAS  Google Scholar 

  10. Tweddel JS, Litwin SB, Berger S, Freidberg DZ, Thomas JP, Frommelt PC, Frommelt MA, Pelech AN, Lewis DA, Fedderly RT, Mussatto KA, Kessel MW. Twenty-year experience with repair of complete atrioventricular septal defects. Ann Thorac Surg 1996; 62: 419–24.

    Article  Google Scholar 

  11. Mavroudis C, Backer CL. The two patch technique for complete atrioventricular canal. Semin Thorac Cardiovasc Surg 1997; 9: 35–43.

    PubMed  CAS  Google Scholar 

  12. Gunther T, Mazzitelli D, Haehnel CJ, Holper K, Sebening F, Meisner H. Long-term results after repair of complete atrioventricular septal defects analysis of risk factors. Ann Thorac Surg 1998; 65: 754–60.

    Article  PubMed  CAS  Google Scholar 

  13. Reddy VM, McElhinney DB, Brook MM, Parry AJ, Hanley FL. Atrioventricular valve function after single patch repair of complete atrioventricular septal defect in infancy: how early should repair be attempted? J Thorac Cardiovasc Surg 1998; 115: 1032–40.

    Article  PubMed  CAS  Google Scholar 

  14. Ebels T, Anderson RH, Devine WA, Debich DE, Penkoske PA, Zuberbuhler JR. Anomalies of the left atrio-ventricular valve and related ventricular septal morphology in atrio-ventricular septal defects. J Thorac Cardiovasc Surg 1990; 99: 299–307.

    PubMed  CAS  Google Scholar 

  15. Shiokawa Y and Becker AE. The left ventricular outflow tract in atrioventricular septal defect revisited: Surgical considerations regarding preservation of aortic valve integrity in the perspective of anatomic observations. J Thorac Cardiovasc Surg 1997; 114(4): 586–93.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Presented in the poster session of the 37th Annual Meeting of Association for European Paediatric Cardiology (AEPC) at Porto, Portugal, May 2002

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kumar, D.A., Suresh Kumar, R., Rao, P. et al. Complete atrioventricular septal defect repair: Simplified single patch technique. Indian J Thorac Cardiovasc Surg 19, 102–107 (2003). https://doi.org/10.1007/s12055-003-0023-2

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12055-003-0023-2

Key words

Navigation