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The Annals of Thoracic Surgery, Vol 30, 151-159, Copyright © 1980 by The Society of Thoracic Surgeons
FM Midgley, FM Galioto, SR Shapiro, LW Perry and LP Scott
Twenty-nine patients at out institution have undergone repair of complete
atrioventricular canal since 1969. There were 3 operative and 5 late
deaths, 4 of which were of infectious etiology. Age at operation ranged
from 2 months to 12 years (mean, 50 months). Weight ranged from 3.6 kg to
30 kg (mean, 12 kg). Before repair, catheterization studies revealed
pulmonary hypertension in all patients with unobstructed pulmonary
arteries. Pulmonary to systemic flow ratio ranged from 1.5 to 10.6 (mean,
3.5). Pulmonary vascular resistance (PVR) ranged from 0.7 to 21.7 (mean,
5.3) Wood units/m2. At repair, 14 patients had Rastelli type A anatomy, 14
had type C, and 1 patient had a variant with crossing chordae and
double-outlet right ventricle (DORV). Postoperative catheterization has
been done in 16 patients 2 months to 8 years (mean, 30 months) after
repair. One patient had residual ventricular shunting and later underwent
successful repair. A 2-year- old patient had severe mitral regurgitation
and died following mitral valve replacement. One patient required a
permanent pacemaker. The 21 surviving patients have been followed from 7
months to 10 years 7 months and have excellent hemodynamic status.
Long-term studies are needed to assess the ultimate effect on patients with
high PVR.
ARTICLES
Experience with repair of complete atrioventricular canal
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