title: Results of one-and-a-half-patch technique for repair of complete atrioventricular septal defect with a large ventricular component.
abstract: OBJECTIVE
  Management of complete atrioventricular (AV) septal defect (CAVSD) with a large ventricular component (>1 cm) remains controversial. The purpose of this study was to assess the feasibility of the one-and-a-half patch technique in repairing this lesion.
  
  
  METHODS
  This was a retrospective review of patients undergoing surgical repair of CAVSD with a large ventricular component (>1 cm). Of the 51 patients who were identified in our database (2005-13), 18 underwent the two-patch repair, 12 underwent the modified single-patch repair and 21 underwent the one-and-a-half-patch repair. The CAVSD was combined with tetralogy of Fallot (TOF) in 3 patients and with double-outlet right ventricle (DORV) and pulmonary stenosis (PS) in two individuals in the one-and-a-half-patch group.
  
  
  RESULTS
  There were two hospital deaths in the two-patch group, but no deaths in the other two groups. The modified single-patch procedure was associated with the shortest myocardial ischaemic and cardiopulmonary bypass (CPB) times, the two-patch procedure was associated with the longest times and the 1.5-patch procedure times were intermediate. Median follow-up was 35 months (41.6 ± 27.2 months). There were no reoperations in the 1.5-patch group while reintervention was required for 1 patient in the two-patch group (P = 0.252) and 3 patients in the modified single-patch group (P = 0.017). The function of the reconstituted AV valves improved after operation in the 1.5-patch group. No patient in these three groups developed subsequent left ventricular outflow tract obstruction.
  
  
  CONCLUSIONS
  The 1.5-patch technique is an attractive clinical option. It produces acceptable mid-term results comparable with two conventional techniques in patients with similarly sized ventricular component.
authors.affiliation: Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Heart Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Guocheng
authors.initials: G
authors.lastname: Shi
authors.affiliation: Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Heart Center, Shanghai Jiaotong University School of Medicine, Shanghai, China hwhwc@hotmail.com.
authors.forename: Huiwen
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Heart Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Haifa
authors.initials: H
authors.lastname: Hong
authors.affiliation: Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Heart Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Haibo
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Heart Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Jinghao
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Heart Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Jingfen
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Heart Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Xu
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods*; D002675:Child, Preschool; D005260:Female; D006343:Heart Septal Defects; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Complete atrioventricular septal defect; Congenital heart disease; Surgical repair