title: Surgical repair of complete atrioventricular defect (Nunn technique).
abstract: Two procedures have been traditionally used for the surgical repair of complete atrioventricular canal. The single-patch technique includes the division of valve leaflets, and the use of one patch to close the ventricular and the atrial septal defects, whereas the double-patch technique uses two separate patches, without the division of the bridging leaflets. Between 1997 and 2007, another technique emerged, the modified single-patch technique, or the 'Australian' technique, whereby the ventricular septal defect (VSD) is closed by the direct apposition of the bridging leaflets against the crest of the defect. Because of the absence of the ventricular septal patch, concerns have been raised about the possible left ventricular outflow tract obstruction (LVOTO), or atrioventricular valve (AVV) distortion, especially in case of a deep VSD, or if the defect extends superiorly. The results of the modified single-patch technique in terms of mortality, immediate and long-term AVV function and LVOTO have been similar to the standard techniques in most reports. This article will describe in detail the operative technique and review the relevant literature.
authors.affiliation: Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon ie13@aub.edu.lb.
authors.forename: Issam
authors.initials: I
authors.lastname: El-Rassi
authors.affiliation: Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Fatimah
authors.initials: F
authors.lastname: Charafeddine
authors.affiliation: Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Anas
authors.initials: A
authors.lastname: Tabbakh
authors.affiliation: Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Aboutaka
authors.affiliation: Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Daniele
authors.initials: D
authors.lastname: Khater
authors.affiliation: Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Mariam
authors.initials: M
authors.lastname: Arabi
authors.affiliation: Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Fadi
authors.initials: F
authors.lastname: Bitar
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000002:abnormalities / Q000601:surgery*; D006343:Heart Septal Defects / Q000601:surgery*; D006351:Heart Valves / Q000002:abnormalities / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D016896:Treatment Outcome
keywords: Atrioventricular septal defect; Congenital heart disease; Heart septal defects