Complete atrioventricular septal defect: comparison of modified single-patch technique with two-patch technique in infants.
BACKGROUND
The purpose of this study was to compare the modified single-patch technique with the two-patch technique for infants with complete atrioventricular septal defects (AVSDs).


METHODS
Between December 2001 and October 2011, 98 infants underwent complete AVSD primary repair. Forty-six patients had a modified single-patch technique; 59 patients had a two-patch technique. Eighty-seven patients had follow-up by echocardiography to measure the degree of valve regurgitation.


RESULTS
There were two deaths (one in modified single-patch group and one in two-patch group). Cross-clamp times and cardiopulmonary bypass times were shorter in the modified single-patch group (70.56 ± 21.05 vs. 83.76 ± 22.74 minutes, p=0.004; 95.02 ± 19.73 vs. 109.9 ± 34.07, p=0.011). There was no patient with third-degree atrioventricular (AV) block in the modified single-patch group, while two patients in the two-patch group required a pacemaker (3.85%, p=NS). During follow-up, one death occurred in the single-patch group and three deaths in the two-patch group. At last follow-up, ten patients had more than moderate left AV valve regurgitation (four in single-patch group vs. six in two-patch group, p=0.886) and eight patients required reoperation (three in single-patch group vs. five in two-patch group, p=0.841). One patient in the single-patch group required reoperation for a residual ventricular septal defect and none in the two-patch group.


CONCLUSIONS
Modified single-patch repair in infants with complete AVSD is a safe and reproducible technique. The results are as good as the two-patch technique. Among long-term survivors, most have very good clinical and functional results and minimal or no regurgitation of either AV valve.
Department of Thoracic and Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, P.R. China.
Gaofeng
G
Pan
Laichun
L
Song
Xuefeng
X
Zhou
Jinping
J
Zhao
D006348:Cardiac Surgical Procedures / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006343:Heart Septal Defects; D006801:Humans; D007223:Infant; D008297:Male; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome