Technique of repair of atrioventricular septal defect with a common atrioventricular orifice

1991 ◽  
Vol 1 (4) ◽  
pp. 379-382 ◽  
Author(s):  
Walter H. Merrill ◽  
John W. Hammon ◽  
Harvey W. Bender
Keyword(s):  
Septal Defect ◽  
Operative Mortality ◽  
Primary Repair ◽  
Atrioventricular Septal Defect ◽  
Atrioventricular Valve ◽  
Ventricular Septal Defects ◽  
Septal Defects ◽  
Technical Details ◽  
Low Incidence ◽  
Patch Technique

SummaryWe advocate primary repair of atrioventricular septal defect with a common atrioventricular orifice in symptomatic children presenting with intractable congestive heart failure. The single patch technique has been utilized as our procedure of choice. A low operative mortality and a low incidence of residual ventricular septal defect and regurgitation of the left atrioventricular valve requiring reoperation has been achieved. This report emphasizes the technical details of the repair. Careful delineation of anatomic detail is considered to be of the utmost importance. Precise suture placement, tailoring the patch, and reconstruction of the left atrioventricular valve are essential to achieve complete closure of the atrial and ventricular septal defects and functional integrity of the left atrioventricular valve.

Management of the left atrioventricular valve in 95 patients with atrioventricular septal defects and a common atrioventricular orifice—a ten year review

1991 ◽  
Vol 1 (4) ◽  
pp. 367-373 ◽  
Author(s):  
François Lacour-Gayet ◽  
Juan Comas ◽  
Jacqueline Bruniaux ◽  
Alain Serraf ◽  
Jean Losay ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Septal Defect ◽  
Primary Repair ◽  
Ventricular Outflow Tract ◽  
Atrioventricular Septal Defect ◽  
Left Ventricular ◽  
Atrioventricular Valve ◽  
Septal Defects ◽  
Left Ventricular Outflow ◽  
The Right

SummaryDuring a 10 year interval, between January 1, 1981 and January 1, 1991, primary repair of atrioventricular septal defect with a common atrioventricular orifice was performed in 95 patients younger than 1 year. Patients with atrioventricular septal defect having two atrioventricular orifices and a small ventricular septal defect, and those with severe hypoplasia of the left ventricle, were not included in the present study. According to the presence of associated anomalies, patients were divided into those with simple forms (72%) and those with complex forms (28%). These included parachute deformity of the left atrioventricular valve (10 cases), multiple muscular ventricular septal defects (5 cases), low-lying infundibular stenosis of the right ventricle (4 cases), obstruction of the left ventricular outflow tract (3 cases), tetralogy ofFallot (2 cases) and hypoplasia of the left ventricle (2 cases).

Significance of left ventricular wall stress in infants with atrioventricular septal defect, common atrioventricular orifice and regurgitation across the left atrioventricular valve

1991 ◽  
Vol 1 (4) ◽  
pp. 390-395
Author(s):  
Masahi Seguchi ◽  
Makoto Nakazawa ◽  
Kataro Oyama ◽  
Masa-aki Kawada ◽  
Hiromi Kurosawa ◽  
...  
Keyword(s):  
Septal Defect ◽  
Primary Repair ◽  
Wall Stress ◽  
Ventricular Volume ◽  
Atrioventricular Septal Defect ◽  
Left Ventricular ◽  
Ventricular Wall ◽  
Atrioventricular Valve ◽  
Left Heart Failure ◽  
Young Infants

SummaryThe outcome of primary repair in young infants having atrioventricular septal defect with a common atrioventricular orifice and regurgitation across the left atrioventricular valve is not yet satisfactory. We studied the significance of the characteristics of left ventricular volume and mass and the predicted wall stress for the outcome of repair in 13 infants with this lesion. Three patients died of left heart failure after operation, although neither residual shunting at ventricular level nor regurgitation across the left atrioventricular valve was present. End-diastolic volume and ejection fraction of the left ventricle were 228 ±66% and 0.65 ±0.06 of normal, respectively, with no difference between the survivors and non-survivors. End-diastolic thickness of the posterior ventricular wall, determined by echocardiogram, was within normal range for body size in all patients.

Swiss-cheese ventricular septal defect closure by combination sandwich patch

2020 ◽  
pp. 021849232097624
Author(s):  
Hajime Sakurai ◽  
Toshimichi Nonaka ◽  
Takahisa Sakurai ◽  
Naoki Ohashi ◽  
Hiroshi Nishikawa
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Fontan Operation ◽  
Defect Closure ◽  
Swiss Cheese ◽  
Ventricular Septal Defects ◽  
Septal Defects ◽  
Ventricular Septal Defect Closure ◽  
History Of ◽  
Patch Technique

A 7-year-old boy with a history of neonatal pulmonary artery banding underwent almost complete closure of a sieve-like “Swiss-cheese” ventricular septal defect, using a combination sandwich patch technique through a right ventriculotomy. Although defects existed in the high-, mid-, and low-trabecular septa, a right ventriculotomy and division of the muscle trabeculations continuing the septal and moderator bands helped delineate the edges of the defects. Although patients with “Swiss-cheese” ventricular septal defects may be candidates for a Fontan operation conventionally, a combination patch technique could be considered the procedure of choice.

Atrioventricular septal defect associated with type A postaxial polydactyly

2004 ◽  
Vol 14 (2) ◽  
pp. 215-218 ◽  
Author(s):  
Solly E. Levin ◽  
Kathy Vanderdonck
Keyword(s):  
Tetralogy Of Fallot ◽  
Septal Defect ◽  
Atrioventricular Septal Defect ◽  
Atrioventricular Valve ◽  
Second Child ◽  
Postaxial Polydactyly ◽  
Atrioventricular Septal Defects ◽  
Septal Defects ◽  
First Case ◽  
Double Orifice

We report two more patients with the association of postaxial polydactyly and atrioventricular septal defects. Additional cardiac findings, not previously described, were tetralogy of Fallot in the first case, and double orifice right atrioventricular valve in the second child.

Primary Surgical Repair of Ventricular Septal Defect

2003 ◽  
Vol 11 (3) ◽  
pp. 213-216 ◽  
Author(s):  
M Kemal Demirag ◽  
Hasan Tahsin Keçeligil ◽  
Fersat Kolbakir
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Surgical Repair ◽  
Primary Repair ◽  
Ventricular Septal Defects ◽  
Atrioventricular Canal ◽  
Residual Shunt ◽  
Mortality And Morbidity ◽  
Septal Defects ◽  
Early Primary

Between January 1983 and December 2000, 78 patients underwent primary repair of a ventricular septal defect. There were 42 males (54%) and 36 females (46%) of whom 13 (17%) were under 1 year old, 50 (64%) were aged 1–10 years, 11 (14%) were aged 10–20 years, and 4 (5%) were over 20 years old. The ventricular septal defect was a perimembranous type in 60 patients (77%), subarterial (outlet) type in 10 (13%), and atrioventricular canal (inlet) type in 4 (5%). Operative repair was performed with a patch in all except 2 patients. Early postoperative complications included insignificant aortic regurgitation in 4 patients, persistent complete heart block in 1, and residual shunt in 4. There were 5 early deaths (6.4%) and 1 late death (1.8%) in 56 patients followed up. Early primary closure of ventricular septal defects, usually via a right atriotomy, can be performed with acceptable mortality and morbidity rates.

What is the optimal time to repair atrioventricular septal defect and common atrioventricular valvar orifice?

2007 ◽  
Vol 17 (4) ◽  
pp. 356-359 ◽  
Author(s):  
Brian E. Kogon ◽  
Hunter Butler ◽  
Michael McConnell ◽  
Traci Leong ◽  
Paul M. Kirshbom ◽  
...  
Keyword(s):  
Intensive Care ◽  
Categorical Data ◽  
Septal Defect ◽  
Atrioventricular Septal Defect ◽  
Optimal Time ◽  
Ventricular Septal Defects ◽  
Atrioventricular Septal Defects ◽  
Septal Defects ◽  
Time Required ◽  
Patent Arterial Duct

AbstractObjectiveWith improvements in technology and surgical technique, paediatric cardiologists are challenging surgeons to repair balanced atrioventricular septal defects in smaller patients. Early repair minimizes aggressive medical therapy to prevent heart failure, maintains growth, and limits exposure to elevated pulmonary pressures. We compare the outcomes of repair among different-sized children.MethodsFrom December 2002 to July 2005, 92 patients underwent repair of an atrioventricular septal defect with common atrioventricular valvar orifice and balanced ventricles. We reviewed operative and postoperative data. We excluded patients weighing more than 10 kilograms, but included those who underwent concomitant closure of a patent oval foramen or atrial septal defect, or ligation of a patent arterial duct. Those requiring other concomitant procedures were excluded from the analysis.ResultsThe median weight at repair was 4.9 kilograms, with a range from 2.93 to 7.9 kilograms, and the median age was 5.1 months, with a range from 0.39 to 9.6 months. Operative data included the time required for cardiopulmonary bypass, aortic cross-clamping, and the overall procedure. These times were not significantly affected by decreasing weight. Postoperative continuous data included duration of ventilation and length of intensive care unit and hospital stay. Stay in intensive care (p = 0.006) and hospital (p = 0.007) both increased significantly with decreasing weight. Postoperative categorical data included presence of residual ventricular septal defects, regurgitation across the left atrioventricular valve, and complications. While there was no difference in residual defects (p = 0.166) or valvar regurgitation (p = 0.729), there was a significantly higher presence of complications with decreasing weight (p = 0.0043). There was no mortality, and no persistent heart block requiring placement of a permanent pacemaker.ConclusionsOur data shows that, with the exception of a slightly longer and more complicated postoperative course, early surgery for symptomatic patients with atrioventricular septal defects and common atrioventricular valvar orifice can be undertaken safely and effectively in smaller children with excellent outcomes.

Technique of management of the left atrioventricular valve in the repair of atrioventricular septal defect with a common atrioventricular orifice

1991 ◽  
Vol 1 (4) ◽  
pp. 356-366 ◽  
Author(s):  
Hillel Laks ◽  
Eli R. Capouya ◽  
Jeffrey M. Pearl ◽  
Amir Elami ◽  
Davis C. Drinkwater
Keyword(s):  
Septal Defect ◽  
Surgical Techniques ◽  
Atrioventricular Septal Defect ◽  
Recent Experience ◽  
Atrioventricular Valve ◽  
Early Outcome ◽  
Atrioventricular Septal Defects ◽  
Septal Defects ◽  
Complete Repair

SummaryDespite improvement in the early outcome for patients undergoing complete repair of atrioventricular septal defects with a common atrioventricular orifice, the incidence of reoperation for failure of the repair of the left atrioventricular valve remains high. The surgical techniques employed in our most recent experience, including routine suture of the septal commissure and liberal use of valvar annuloplasty, were successful in achieving a very satisfactory competence of left atrioventricular valve with a iow incidence of reoperation for failure of the repair.

Symptomatic partial and transitional atrioventricular septal defect repaired in infancy

Heart ◽  
2017 ◽  
Vol 104 (17) ◽  
pp. 1411-1416 ◽  
Author(s):  
Sylvia Krupickova ◽  
Gareth J Morgan ◽  
Mun Hong Cheang ◽  
Michael L Rigby ◽  
Rodney C Franklin ◽  
...  
Keyword(s):  
Septal Defect ◽  
Surgical Repair ◽  
Primary Repair ◽  
Nyha Class ◽  
Multivariable Analysis ◽  
Heart Association ◽  
Reoperation Rate ◽  
Atrioventricular Septal Defect ◽  
Atrioventricular Valve ◽  
Atrioventricular Valve Regurgitation

ObjectivesInfants with symptomatic partial and transitional atrioventricular septal defect undergoing early surgical repair are thought to be at greater risk. However, the outcome and risk profile of this cohort of patients are poorly defined. The aim of this study was to investigate the outcome of symptomatic infants undergoing early repair and to identify risk factors which may predict mortality and reoperation.MethodsThis multicentre study recruited 51 patients (24 female) in three tertiary centres between 2000 and 2015. The inclusion criteria were as follows: (1) partial and transitional atrioventricular septal defect, (2) heart failure unresponsive to treatment, (3) biventricular repair during the first year of life.ResultsMedian age at definitive surgery was 179 (range 0–357) days. Sixteen patients (31%) had unfavourable anatomy of the left atrioventricular valve: dysplastic (n=7), double orifice (n=3), severely deficient valve leaflets (n=1), hypoplastic left atrioventricular orifice and/or mural leaflet (n=3), short/poorly defined chords (n=2). There were three inhospital deaths (5.9%) after primary repair. Eleven patients (22%) were reoperated at a median interval of 40 days (4 days to 5.1 years) for severe left atrioventricular valve regurgitation and/or stenosis. One patient required mechanical replacement of the left atrioventricular valve. After median follow-up of 3.8 years (0.1–11.4 years), all patients were in New York Heart Association (NYHA) class I. In multivariable analysis, unfavourable anatomy of the left atrioventricular valve was the only risk factor associated with left atrioventricular valve reoperation.ConclusionsAlthough surgical repair is successful in the majority of the cases, patients with partial and transitional atrioventricular septal defect undergoing surgical repair during infancy experience significant morbidity and mortality. The reoperation rate is high with unfavourable left atrioventricular valve anatomy.

A ten year review of atrioventricular septal defects

2004 ◽  
Vol 14 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Kathryn A. Dunlop ◽  
H. Connor Mulholland ◽  
Frank A. Casey ◽  
Brain Craig ◽  
Dennis J. Gladstone
Keyword(s):  
Cardiac Surgery ◽  
Septal Defect ◽  
Operative Mortality ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Atrioventricular Septal Defect ◽  
Retrospective Case ◽  
Atrioventricular Septal Defects ◽  
Septal Defects

Objectives:To review all cases of atrioventricular septal defects in Northern Ireland from January 1990 to February 1999, examining clinical and morphological features, management, and outcome.Methods:A retrospective case note analysis of 106 subjects with comparisons between subgroups.Results:An atrioventricular septal defect was part of a more complex abnormality in 50 of the patients (47%). Down's syndrome was present in 57 (54%). Cardiac surgery was performed in 81%. The defects were unrestrictive in 69 patients (65%), 45 of whom had Down's syndrome. Complex associated abnormalities existed in 36 patients, and 10 of these died without cardiac surgery. Operative mortality was 9.5% for those with co-existing Down's syndrome group, and 14.3% for the chromosomally normal patients. The ventricular components of the septal defect were restrictive in 23 patients (22%), with 9 having Down's syndrome. Spontaneous closure occurred in more than half of these patients. Mortality was zero. The septal defect was exclusively at atrial level in 14 patients (“primum” defects – 13%), and 3 of these had Down's syndrome. Operative mortality was again zero. Median duration of postoperative follow-up was 3 and a half years. Overall, moderate to severe left atrioventricular valvar regurgitation was observed postoperatively in 23% at follow-up.Conclusions:Mortality was highest in the atrioventricular septal defects with an unrestrictive ventricular component. Uncomplicated cases had good outcomes. Patients without Down's syndrome tended to have more associated cardiac abnormalities, and to have more postoperative arrhythmias. Approximately half of the defects with restrictive ventricular components closed spontaneously. Moderate postoperative left atrioventricular valvar regurgitation was commonest in patients with the defect exclusively at atrial level.

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