ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
The repair of atrioventricular septal defect: simplified single patch or double patch?
Yavuz Enç 1, Numan Ali Aydemir 1, Umut Ayoğlu 1, Yalım Yalçın 2, Tuğçin Bora Polat 2, Batuhan Özay1, Hakan Kutlu 1, Alper Görür 1, Sertaç Çiçek1
1Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Çocuk Kalp Cerrahisi Kliniği, İstanbul
2Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Çocuk Kardiyolojisi Kliniği, İstanbul
Background: As the traditional single and double patch repair of atrioventricular canal defects are complex, a modified single patch repair, in which ventricular septal defect component is repaired by direct suture, was described in 1999. We compared the results of patients who underwent total correction with the traditional double patch and this modified single patch techniques.

Methods: Forty-five children (30 girls, 15 boys; mean age 9.4±5.0 months) with common atrioventricular defect were randomized for total correction by two separate teams. Group I (31 children) was assigned to traditional double patch repair and group II (14 children) was assigned to the modified single patch technique called the Australian repair. The two groups were compared with regard to perioperative variables and postoperative echocardiographic findings on ventricular function, atrioventricular valve function, and left ventricular outflow tract obstruction.

Results: The mean body weight was 6.8±1.7 kg. There were significant differences between the two groups with regard to operative variables. The mean cross-clamp time was 104.4±4.19 min in group I, and 78.6±6.1 min in group II (p<0.001). The mean cardiopulmonary bypass time was 123.9±5.2 min in group I, and 95.5±3.59 min in group II (p<0.001). Early mortality was seen in eight patients (18%), with no significant difference between the two groups. Within a mean of 21-month follow-up period, three patients died in group I, and one patient died in group II. There were no significant differences in late echocardiographic mitral and tricuspid valve functions between the two groups.

Conclusion: The modified single patch technique facilitates repair considerably and reduces cross-clamp and cardiopulmonary bypass times significantly without giving rise to left ventricular outflow tract obstruction and valve incompetence.

Keywords : Echocardiography; heart septal defects/surgery/ methods; heart valves/surgery; infant; mitral valve insufficiency; tricuspid valve insufficiency
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