HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Ian A. Nicholson Graham R. Nunn Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nicholson, I. A. Articles by Cohn, S. L. H. Search for Related Content PubMed PubMed Citation Articles by Nicholson, I. A. Articles by Cohn, S. L. H.

J Thorac Cardiovasc Surg 1999;118:642-647
© 1999 Mosby, Inc.

SURGERY FOR CONGENITAL HEART DISEASE

SIMPLIFIED SINGLE PATCH TECHNIQUE FOR THE REPAIR OF ATRIOVENTRICULAR SEPTAL DEFECT

From the Adolph Basser Cardiac Institute, New Children’s Hospital, Westmead, New South Wales, Australia.

Address for reprints: Graham Nunn, FRACS, Adolph Basser Cardiac Institute, New Children’s Hospital, Westmead NSW 2145, Australia.

Objective: Because of the complexity of traditional 1- and 2-patch techniques for the repair of complete atrioventricular septal defect, we modified our repair technique to avoid the use of any ventricular septal patch material. We report our prospective experience with this simplified 1-patch technique.
Method: Forty-seven consecutive patients between May 1995 and August 1998 underwent repair with the use of this technique without modification. Repair was done in all patients by direct suturing of the common atrioventricular valve leaflets to the crest of the ventricular septum. No division of valve leaflets was necessary. A single pericardial patch was used to close the defect in the atrial septal component. Follow-up included electrocardiography and echocardiographic assessment of ventricular function, atrioventricular valve function, and adequacy of the left ventricular outflow tract.
Results: There were 2 deaths (4%), only 1 cardiac related, in the series. There were 17 male patients and 30 female patients. Mean age at repair was 5.6 months (median, 3.4 months). Associated lesions were repaired in 19 patients (40%). Mean follow-up was 1.85 years (median, 1.9 years). There was no heart block. There were no significant residual ventricular septal defects detected and no left ventricular outflow tract obstruction seen on echocardiography in any patient to date. Mitral valve status after operation was assessed as no incompetence in 13 patients (28%), minimal in 19 patients (40%), mild in 12 patients (26%), and moderate in 3 patients (6%).
Conclusion: The repair of complete atrioventricular septal defect by direct suturing of the atrioventricular valve leaflets to the crest of the ventricular septum with a single-patch technique greatly simplifies the repair and does not lead to left ventricular outflow tract obstruction nor interfere with valve function.

This article has been cited by other articles:

				A. Dragulescu, V. Fouilloux, O. Ghez, A. Fraisse, B. Kreitmann, and D. Metras Complete Atrioventricular Canal Repair Under 1 Year: Rastelli One-Patch Procedure Yields Excellent Long-Term Results Ann. Thorac. Surg., November 1, 2008; 86(5): 1599 - 1606. [Abstract] [Full Text] [PDF]

				A. Dodge-Khatami, S. Herger, V. Rousson, M. Comber, W. Knirsch, U. Bauersfeld, and R. Pretre Outcomes and reoperations after total correction of complete atrio-ventricular septal defect Eur. J. Cardiothorac. Surg., October 1, 2008; 34(4): 745 - 750. [Abstract] [Full Text] [PDF]

				C. L. Backer Invited commentary. Ann. Thorac. Surg., August 1, 2008; 86(2): 602 - 603. [Full Text] [PDF]

				A. M. Gaca, J. J. Jaggers, L. T. Dudley, and G. S. Bisset III Repair of Congenital Heart Disease: A Primer--Part 2 Radiology, July 1, 2008; 248(1): 44 - 60. [Abstract] [Full Text] [PDF]

				C. L. Backer, R. D. Stewart, F. Bailliard, A. M. Kelle, C. L. Webb, and C. Mavroudis Complete Atrioventricular Canal: Comparison of Modified Single-Patch Technique With Two-Patch Technique Ann. Thorac. Surg., December 1, 2007; 84(6): 2038 - 2046. [Abstract] [Full Text] [PDF]

				J. I. Aramendi, M. A. Rodriguez, T. Luis, and R. Voces No patch technique for complete atrioventricular canal repair Interactive CardioVascular and Thoracic Surgery, August 1, 2006; 5(4): 349 - 352. [Abstract] [Full Text] [PDF]

				S. Tatebe, Y. Saji, K. Aoki, and S. Kuraoka Intermediate type atrioventricular septal defect in the elderly. Ann. Thorac. Surg., May 1, 2006; 81(5): 1888 - 1890. [Abstract] [Full Text] [PDF]

				E. Prifti, M. Bonacchi, M. Bernabei, A. Crucean, B. Murzi, F. Bartolozzi, V. S. Luisi, M. Leacche, N. S. Nathan, and V. Vanini Repair of complete atrioventricular septal defects in patients weighing less than 5 kg Ann. Thorac. Surg., May 1, 2004; 77(5): 1717 - 1726. [Abstract] [Full Text] [PDF]

				F. A. Crawford Jr and M. R. Stroud Surgical repair of complete atrioventricular septal defect Ann. Thorac. Surg., November 1, 2001; 72(5): 1621 - 1629. [Abstract] [Full Text] [PDF]

				M. Chikada, A. Sekiguchi, T. Miyamoto, M. Matsuzaki, R. Ishida, and A. Ishizawa Direct closure of ostium primum defect in the repair of atrioventricular septal defect Ann. Thorac. Surg., August 1, 2001; 72(2): 430 - 432. [Abstract] [Full Text] [PDF]