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The Annals of Thoracic Surgery, Vol 38, 157-161, Copyright © 1984 by The Society of Thoracic Surgeons
EL Bove, HM Sondheimer, RE Kavey, CJ Byrum and MS Blackman
From May, 1982, to September, 1983, 9 patients underwent repair of complete
AV septal defect. They ranged in age from 11 months to 48 months and in
weight from 5.3 kg to 16.5 kg. Seven patients were 24 months old or less.
Previous operations included pulmonary artery banding in 1 patient and
ligation of a patent ductus arteriosus with repair of coarctation in
another. All patients had large left-to-right shunts (mean pulmonary to
systemic flow ratio, 3.1), and the 7 young infants had marked pulmonary
hypertension. Mitral regurgitation was absent in 2 patients, mild in 3,
moderate in 2, and severe in 2. One patient had the right ventricular
dominant form of complete AV septal defect. In all instances, repair was
done using separate ventricular and atrial patches. Leaflet tissue was not
divided, and a trileaflet mitral valve was left in each patient. Eight
patients survived operation and are well 3 to 17 months after repair. The
single operative death occurred in the patient with right ventricular
dominance. Only 1 patient has mild residual heart failure 4 months after
operation. Clinically, mitral regurgitation is absent in 4 patients and, at
most, mild in the other 4. No patient has a conduction disturbance. Repair
of complete AV septal defect is facilitated by using separate patches for
the ventricular and atrial components of the defect. Less distortion is
created, and a more accurate reconstruction of a competent trileaflet
mitral valve can be done.
ARTICLES
Results with the two-patch technique for repair of complete atrioventricular septal defect
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