Complete Atrioventricular Septal Defects "Outcome of Different Techniques"

Abstract
Background: In complete atrioventricular septal defect (CAVSD), a single atrioventricular valve annulus, a common atrioventricular valve, and a defect of the inlet ventricular septum are observed. The deficiency of the atrioventricular septum also results in the presence of a large primum atrial septal defect.
Details of the anatomy, particularly the morphology of the atrioventricular valve are crucial in planning surgical repair of this lesion.
Total repair of such cardiac lesion is now spreading with intentions to save children at younger age and lower body weight.
Improved technical methods and post-operative manage-ment have resulted in declining mortality over time.
Aim of Study: The purpose of this study was to compare the outcome of different surgical modalities in total repair of complete atrioventricular canal defects either single patch or double patches techniques.
Patients and Methods: This study was conducted at (Al-Hussin University Hospital, Pediatric Unit of National Heart Institute, Cairo University Specialized Pediatric Hospital & Atfal Misr Hospital).
Between 2015 and 2017, fifty children with complete atrioventricular canal defects were operated upon. 50 Children with complete atrioventricular canal defects were divided into two groups: Group A included 30 patients who had total repair with single patch technique, and Group B included 20 patients who had total repair with double patches technique.
Results: Of 50 patients, 72% of them had Down Syndrome (DS). There were 3 mortalities distributed as 2 patients (6.7%) in Group A & 1 patient (5%) in Group B, while 2 patients were lost during follow-up.
Fourty five patients had followed-up by echocardiography to measure the degree of valve regurgitation.
At last follow-up, ten patients had moderate or more than moderate left AV valve regurgitation distributed as moderate in 4 patients (14.8%) & severe in 1 patient (3.7%) in Group I & 4 patients (22.2%), 1 patient (5.6%) in Group II respec-tively.
Conclusion: Modified single-patch repair in infants with complete AVSD is a safe and reproducible technique. The results are as good as the two-patch technique. Among long-term survivors, most have very good clinical and functional results and minimal or no regurgitation of either AV valves.