BACKGROUND: The purpose of this study was to compare the modified single-patch technique with the two-patch technique for infants with complete atrioventricular septal defects (AVSDs). METHODS: Between December 2001 and October 2011, 98 infants underwent complete AVSD primary repair. Forty-six patients had a modified single-patch technique; 59 patients had a two-patch technique. Eighty-seven patients had follow-up by echocardiography to measure the degree of valve regurgitation. RESULTS: There were two deaths (one in modified single-patch group and one in two-patch group). Cross-clamp times and cardiopulmonary bypass times were shorter in the modified single-patch group (70.56 ± 21.05 vs. 83.76 ± 22.74 minutes, p=0.004; 95.02 ± 19.73 vs. 109.9 ± 34.07, p=0.011). There was no patient with third-degree atrioventricular (AV) block in the modified single-patch group, while two patients in the two-patch group required a pacemaker (3.85%, p=NS). During follow-up, one death occurred in the single-patch group and three deaths in the two-patch group. At last follow-up, ten patients had more than moderate left AV valve regurgitation (four in single-patch group vs. six in two-patch group, p=0.886) and eight patients required reoperation (three in single-patch group vs. five in two-patch group, p=0.841). One patient in the single-patch group required reoperation for a residual ventricular septal defect and none in the two-patch group. CONCLUSIONS: 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 valve.
BACKGROUND: The purpose of this study was to compare the modified single-patch technique with the two-patch technique for infants with complete atrioventricular septal defects (AVSDs). METHODS: Between December 2001 and October 2011, 98 infants underwent complete AVSD primary repair. Forty-six patients had a modified single-patch technique; 59 patients had a two-patch technique. Eighty-seven patients had follow-up by echocardiography to measure the degree of valve regurgitation. RESULTS: There were two deaths (one in modified single-patch group and one in two-patch group). Cross-clamp times and cardiopulmonary bypass times were shorter in the modified single-patch group (70.56 ± 21.05 vs. 83.76 ± 22.74 minutes, p=0.004; 95.02 ± 19.73 vs. 109.9 ± 34.07, p=0.011). There was no patient with third-degree atrioventricular (AV) block in the modified single-patch group, while two patients in the two-patch group required a pacemaker (3.85%, p=NS). During follow-up, one death occurred in the single-patch group and three deaths in the two-patch group. At last follow-up, ten patients had more than moderate left AV valve regurgitation (four in single-patch group vs. six in two-patch group, p=0.886) and eight patients required reoperation (three in single-patch group vs. five in two-patch group, p=0.841). One patient in the single-patch group required reoperation for a residual ventricular septal defect and none in the two-patch group. CONCLUSIONS: 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 valve.
Authors: Mohannad Ali Dawary; Faisal Dkhalallah Alshamdin; Louai Hassan Alkhalaf; Ahmed Othman Alkhamis; Fareed Ahmed Khouqeer Journal: Ann Saudi Med Date: 2019-12-05 Impact factor: 1.526
Authors: Laura S Fong; David Youssef; Julian Ayer; Ian A Nicholson; David S Winlaw; Yishay Orr Journal: Interact Cardiovasc Thorac Surg Date: 2022-02-21