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Original Articles: Pediatric Cardiac

Invited Commentary

Division of Cardiovascular-Thoracic Surgery, Children's Memorial Hospital, Feinberg School of Medicine, 2300 Children's Plaza, MC 22, Chicago, IL 60614

(Email: cbacker@childrensmemorial.org).

The first 20% of the full text of this article appears below.

In 1995, we reported our results with the two-patch technique for complete atrioventricular (AV) septal defect from the Children's Memorial Hospital [1]. For a series that started in 1983, we believed that we had fairly good results with an operative mortality of 7%, reoperation for left AV valve insufficiency of 7%, and reoperation for left ventricular outflow tract (LVOT) obstruction of 4%. The series reported by Suzuki and colleagues [2] demonstrates that the results with the two-patch technique have continued to improve since 1995. Operative mortality in this University of Michigan series is only 2%. The age at time of repair decreased from a median age of 8 months in our series to 4.8 months in this current series. In fact, one of the reasons for this improvement in outcomes is the younger age at the time of repair. This decreases the complications caused by postoperative pulmonary hypertension and progressive dilatation of the AV valve with resultant AV valve insufficiency.

The two outcome measures that do not seem to have changed for the past 10 years are the incidence of reoperation on the left AV . . . [Full Text of this Article]

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Ann. Thorac. Surg. 2008 86: 596-602. [Abstract] [Full Text] [PDF]