title: Repair of subaortic stenosis in atrioventricular canal with absent or restrictive interventricular communication by patch augmentation of ventricular septum, resuspension of atrioventricular valves, and septal myectomy.
abstract: OBJECTIVE
  To describe a modification of a surgical technique for relief of subaortic stenosis in patients with atrioventricular canal.
  
  
  METHODS
  We report an etiology-oriented modified technique of repair of subaortic stenosis after previous repair of atrioventricular canal, without (N = 2) or with (N = 1) a restrictive interventricular communication.
  
  
  RESULTS
  In addition to a generous myectomy of the left ventricular septum, the technique consists of complete detachment of the left and right atrioventricular valves from the ventricular crest, patch augmentation of the concavity of the ventricular crest, and attachment of both atrioventricular valves at the superior aspect of the ventricular septal patch; thus, the septal leaflet of the left atrioventricular valve--in particular, its superior component--is lifted away from the elongated left ventricular outflow tract.
  
  
  CONCLUSIONS
  This modification (as opposed to detachment of only the superior component of the septal leaflet of the left atrioventricular valve, as performed in previously proposed techniques) may be a valuable adjunctive technique to relieve subaortic obstruction associated with atrioventricular canal. In addition, this modification allows a secure anchoring of the patch to the right of the ventricular septum and therefore is associated with minimal risk of damaging the conduction tissue and of causing regurgitation of the left atrioventricular valve.
authors.affiliation: Department of Cardiac Surgery, University of Leipzig, Germany.
authors.forename: J A
authors.initials: JA
authors.lastname: van Son
authors.forename: P
authors.initials: P
authors.lastname: Schneider
authors.forename: V
authors.initials: V
authors.lastname: Falk
mesh_terms: D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D002675:Child, Preschool; D004452:Echocardiography; D006343:Heart Septal Defects / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008943:Mitral Valve / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D014261:Tricuspid Valve / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*