title: Mid-to-long term follow-up after surgical repair of atrioventricular septal defect with common atrioventricular junction and ventricular shunting associated with tetralogy of Fallot.
abstract: OBJECTIVE
  Our aim is to describe our surgical approach in dealing with patients having atrioventricular septal defect with common atrioventricular junction and ventricular shunting associated with tetralogy of Fallot over the last 8 years, and to present our results in mid-to-long term follow-up.
  
  
  METHODS
  Between November 1995 and January 2004, we performed surgical correction in 8 consecutive children with atrioventricular septal defect, common atrioventricular junction, interventricular shunting, and associated tetralogy of Fallot. The age at surgical correction varied from 8 months to 20 years, with a mean of 45 months, and standard deviation of 74 months. A palliative systemic-to-pulmonary shunt had previously been performed in 3 patients. Follow-up ranged from 57 to 135 months, with a mean of 93.5 months, and standard deviation of 32 months. We used a two-patch technique to repair of the atrioventricular septal defect, and a pericardial transjunctional patch for relief of the obstruction in the right ventricular outflow tract.
  
  
  RESULTS
  There were no deaths, nor reoperations either in the postoperative period or during follow-up. All patients are asymptomatic, or in the second class created by the New York Heart Association. The mean period of cardiopulmonary by-pass was 136 minutes, and the mean stay in hospital was 11.8 days. At the last examination, pulmonary valvar insufficiency was considered severe in 2 patients, and moderate in another 2. No patient developed more than a trace of regurgitation across the reconstituted left atrioventricular valve.
  
  
  CONCLUSIONS
  The two-patch technique, associated with ventriculotomy and a transjunctional pulmonary patch is safe and efficient when correcting atrioventricular septal defect associated with tetralogy of Fallot, resulting in good mid-to-long term clinical outcomes.
authors.affiliation: Cardiac Surgery Department, Pro-Cardíaco Hospital, Vieira Souto Avenue no. 208, Ipanema, Rio de Janeiro, Brazil. leonardo.canale@gmail.com
authors.forename: Leonardo S
authors.initials: LS
authors.lastname: Canale
authors.forename: Andrey J O
authors.initials: AJ
authors.lastname: Monteiro
authors.forename: Isabela
authors.initials: I
authors.lastname: Rangel
authors.forename: Divino F
authors.initials: DF
authors.lastname: Pinto
authors.forename: Paulo
authors.initials: P
authors.lastname: Soares
authors.forename: Rosa C
authors.initials: RC
authors.lastname: Barbosa
authors.forename: Milton A
authors.initials: MA
authors.lastname: Meier
authors.forename: Miguel L B
authors.initials: ML
authors.lastname: Marcial
mesh_terms: D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D011184:Postoperative Period; D012086:Reoperation; D012189:Retrospective Studies; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D016276:Ventricular Function / Q000502:physiology