HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Carl L. Backer Robert D. Stewart Catherine L. Webb Constantine Mavroudis Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Backer, C. L. Articles by Mavroudis, C. Search for Related Content PubMed PubMed Citation Articles by Backer, C. L. Articles by Mavroudis, C. Related Collections Congenital - cyanotic

---

Original Articles: Cardiovascular

Complete Atrioventricular Canal: Comparison of Modified Single-Patch Technique With Two-Patch Technique

Divisions of Cardiovascular Thoracic Surgery, and Cardiology, Children’s Memorial Hospital, and the Department of Surgery and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois

Accepted for publication April 23, 2007.

^_* Address correspondence to Dr Backer, Division of Cardiovascular Thoracic Surgery, Children’s Memorial Hospital, 2300 Children’s Plaza, MC #22, Chicago, IL 60614 (Email: cbacker{at}childrensmemorial.org).

Presented at the Forty-third Annual Meeting of The Society of Thoracic Surgeons, San Diego, CA, Jan 29–31, 2007.

Background: The purpose of this study was to compare the modified single-patch technique to the two-patch technique for infants with complete atrioventricular canal (CAVC) defects.

Methods: Between January 2000 and June 2006, 55 infants underwent CAVC repair. Twenty-six patients had a modified single-patch technique; 29 patients had a two-patch technique. Trisomy 21 was present in 23 of 26 and 26 of 29 patients (p = not significant [ns]). Mean age was 4.4 ± 1.3 months (single-patch) versus 5.5 ± 1.9 months (two-patch, p < 0.02). Mean weight was 4.74 ± 0.92 versus 5.28 ± 1.67 kilograms (p = ns).

Results: There was one death in the modified single-patch group (postoperative day 130, liver failure) and no deaths in the two-patch group. Cross-clamp times and cardiopulmonary bypass times were shorter in the modified single-patch group (97.3 ± 19.9 vs 123.3 ± 28.2 minutes, p < 0.0003; 128 ± 25 vs 157 ± 37, p < 0.03). Rastelli classification was type A (18 vs 14), B (1 vs 0), and C (7 vs 15). Mean size of the ventricular septal defect as assessed by transesophageal echocardiogram was 9 ± 2 mm, (single-patch) versus 10 ± 3 mm (two-patch) (p = ns). Median postoperative length of stay did not differ (10 vs 8 days). There was no difference in the degree of postoperative left or right AV valve insufficiency as assessed by serial echocardiography. One patient (4%) required reoperation for mitral insufficiency in the modified single-patch versus three patients in the two-patch group (10%, p = ns). There were no patients with third degree atrioventricular block or that required reoperation for residual VSD in the modified single-patch group. There was one patient with third-degree AV block that required a pacemaker and one patient who had reoperation for a residual ventricular septal defect in the two-patch group (p = ns). No patient in either group required reoperation for left ventricular outflow tract obstruction.

Conclusions: The modified single-patch technique produced results comparable with the two-patch technique in younger patients with similarly sized ventricular septal defects. Furthermore, the modified single-patch technique was performed with significantly shorter cross-clamp and cardiopulmonary bypass times.