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TECHNICAL NOTES  CARDIAC SECTION 

The Journal of Cardiovascular Surgery 2003 April;44(2):227-9

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

A novel technique for the repair of complete atrioventricular septal defects: simplified 2-patch technique

Tireli E., Basaran M.

Department of Cardiovascular Surgery Medical Faculty of Istanbul University Istanbul, Turkey


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­Today com­plete atri­o­ven­tric­ular ­septal ­defects can be cor­rected ­with accept­able mor­tality and post­op­er­a­tive mor­bidity. ­Although opin­ions ­still ­differ ­regarding the ­most appro­priate ­method of ­choice, ­some sur­geons ­have pro­posed a new tech­nique ­that ­involves the ­direct ­suturing of ­common atri­o­ven­tric­ular ­valve leaf­lets to the ­crest of the ven­tric­ular ­septum. How­ever, we ­believe ­that ­this new ­approach may be asso­ciated ­with ­left ven­tric­ular out­flow ­tract obstruc­tion and neo­mi­tral ­valve regur­gi­ta­tion. To ­avoid ­these poten­tial com­pli­ca­tions, we ­decided to ­modify our ­repair tech­nique in 2 ­patients. In ­this sim­pli­fied 2-­patch tech­nique, the oper­a­tion was ­done by ­direct ­suturing of pos­tero-infe­rior ­common ­bridging ­leaflet to the ven­tric­ular ­crest ­while the ­space ­under the ­antero-­superior ­bridging ­leaflet was ­closed ­with a ­small tri­an­gular ­shaped ­Dacron ­patch. No echoc­ar­di­o­graphic evi­dence of neo­mi­tral ­valve regur­gi­ta­tion and ­left ven­tric­ular out­flow ­tract obstruc­tion ­were ­detected in ­either ­early or ­late post­op­er­a­tive exam­ina­tions of ­these ­patients.

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