Early Correction of Common Atrioventricular Septal Defects: A Single-Center 20-Year Experience

Abstract

Individualized early repair of CAVCD is safe and beneficial, with good early and long-term results.

Hybrid approach: an alternative prior to corrective surgery in a patient with arch hypoplasia and complete atrioventricular septal defect

“…[8,9] Recently, although timing for corrective surgery of AVSD has been reduced to early infant stage, corrective surgery is not preferred in patients under two months of age. Vida et al [6] reported good results in 8-12 week-old patients who underwent corrective surgery. Although similar studies exist, our patient was younger than two months and had associated arch hypoplasia.…”

“…[4] Recent surgical techniques, myocardial protection methods and developments in postoperative care have lowered mortality rates of the surgery performed at an early age. [4,5] While results of a study by Vida et al [6] on 8-12 week old infants that underwent total repair surgery are promising, corrective surgery is avoided in younger babies due to the difficulties of repairing delicate valve tissue. [7] Our patient had a very large VSD, aortic arch hypoplasia with minor arch anomaly (common branching of the right brachiocephalic artery and the left carotid artery-bovine trunk) arcus aorta hypoplasia (branching out of the truncus brachiocephalicus of the left main carotid artery), wide PDA, AV valve insufficiency (1-2 degree), and persistent left superior vena cava (SVC).…”

Autopsy in adults with congenital heart disease (ACHD)

“…Surgical correction with closure of interatrial and interventricular components, along with repair and reconstruction of atrioventricular valves, is done. After repair of an AVSD, a re-intervention may be needed for left-sided valve insufficiency or stenosis, often years after repair, with rate of re-intervention of about 10% [20].…”

Reoperation for left atrioventricular valve failure in repaired atrioventricular septal defect: Can more valves be preserved in the current era?

“…Results of atrio‐ventricular septal defect (AVSD) repair in the current era have proved to be excellent in the short and long term but postoperative left atrio‐ventricular valve (LAVV) regurgitation can still be a significant problem and is estimated to occur in up to 18% of patients . Risk factors for LAVV regurgitation such as presence of dysplastic, double orifice, or parachute LAVV have been identified, as have strategies to reduce the risk, including early primary repair, routine cleft closure, and annular stabilization . Nonetheless, LAVV regurgitation remains the main reason for reoperation after AVSD repair …”

“…[4][5][6][7][8][9] Risk factors for LAVV regurgitation such as presence of dysplastic, double orifice, or parachute LAVV have been identified, 6,[10][11][12][13][14][15] as have strategies to reduce the risk, including early primary repair, routine cleft closure, and annular stabilization. 2,[10][11][12][16][17][18][19] Nonetheless, LAVV regurgitation remains the main reason for reoperation after AVSD repair. 4,[7][8][9][10][11][12][13] At the time of redo-surgery, LAVV repair techniques are normally considered preferable to replacement due preservation of the subvalvar apparatus, improved long-term left ventricular function, and potential for growth.…”