ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
The assessment of modified single-patch and two-patch techniques in complete atrioventricular septal defects and our short-term results
Ahmet Şaşmazel1, Ayşe Yıldırım2, Ayşe Baysal3, Ahmet Çalışkan1, Hasan Erdem1, Onursal Buğra1, Hasan Sunar1, Rahmi Zeybek1
1Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul
2Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Pediatrik Kardiyoloji Kliniği, İstanbul
3Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Anestezi ve Reanimasyon Kliniği, İstanbul
DOI : 10.5606/tgkdc.dergisi.2011.039
Background: This study aims to compare the postoperative shortterm results of the modified single-patch technique with those of the two-patch technique in infants with complete atrioventricular septal defects (AVSD).

Methods: Twenty-nine patients ( 16 m ales, 13 females; mean age 7.7±7.8 months; range; 3-36 months) who were diagnosed with AVSD and underwent surgical repair between July 2007 and November 2009 in our clinic were retrospectively evaluated. The patients were divided into two groups depending on the surgical technique. In group 1, the modified single-patch technique (n=11; 38%) and in group 2, the modified two-patch technique (n=18; 62%) were used. Gender, body weight, body surface area, cross-clamp time, cardiopulmonary bypass time, duration of mechanical ventilation, preoperative and postoperative pulmonary arterial pressures, duration of intensive care unit stay, morbidity, mortality and postoperative echocardiographic results of the patients were compared in both groups.

Results: Rastelli type A was seen in 10 patients (91%) in group 1 and in 16 patients (89%) in group 2 (p=0.86). Cardiopulmonary bypass and aortic clamp times were shorter in group 1 than in group 2 (96.7±25.1 vs. 138±63.9 minutes and 70.5±23.1 vs. 92.3±17.1, respectively; p=0.01). Postoperative mild left-sided atrioventricular valve insufficiency was observed in the echocardiographic evaluation of three patients (1 patient in group 1 and 2 patients in group 2). A moderate degree of left-sided atrioventricular valve insufficiency was observed only in one patient of group 1. Left ventricular outflow tract obstruction was not detected in either groups postoperatively. There were three (27%) deaths in group 1 and two deaths (11%) in group 2 in the early postoperative period. No mortality was observed during follow-up of 12 months after surgery. In group 2, one patient (5%) developed complete atrioventricular blockage in the postoperative period and a permanent pacemaker was implanted.

Conclusion: The modified single-patch technique can be performed with acceptable results in infants with complete AVSD when compared with the double-patch technique. The modified single-patch technique can be performed with a shorter cardiopulmonary bypass time.

Keywords : Complete atrioventricular septal defect; modified single-patch technique; modified two-patch technique
Viewed : 12923
Downloaded : 2698