The Annals of Thoracic Surgery, Vol 39, 234-237, Copyright © 1985 by The Society of Thoracic Surgeons
Complete endocardial cushion defect: the late result of repair using the single-patch technique
S Stewart, P Harris and J Manning
Twenty-two patients have been followed for between 1 and 105 months after
repair of a complete endocardial cushion defect. The mean period of
follow-up is 3.5 years. The single-patch technique was used in every
patient. The mitral valve was repaired with buttressed sutures in those
seen more recently. The mean age at the time of operation was 15 months.
Early in this experience, 4 patients had severe mitral valve incompetence
after an initially satisfactory repair. In none of those patients had the
mitral valve been repaired with pledgeted sutures. Two of those patients
survived reoperation, and 2 died before a second operation could be
performed. Every mitral valve is now repaired with pledgeted sutures, and
there have been no failures of the mitral valve reconstruction. Each
patient has been followed by the same pediatric cardiologist every 6 to 12
months after operation. The vast majority (17 of 20) are asymptomatic.
Twelve have no mitral valve incompetence, and the remainder have only
trivial or mild incompetence. Clinically, the pulmonary artery hypertension
has resolved in 19 of 20 patients. Each patient remains in normal sinus
rhythm. The long-term results following repair of complete endocardial
cushion defect with the single- patch technique are excellent, but
pledgeted sutures should be used in the mitral valve repair to insure its
integrity.