Traditional single patch versus the “Australian” technique for repair of complete atrioventricular canal defects

Abstract

The "Australian" technique is a simpler method requiring shorter aortic cross-clamping and total bypass times with good clinical and functional results. The early postoperative results are as encouraging as those achieved by the traditional single patch technique; however, long-term follow-up results are required to establish the efficacy of this simplified technique.

Surgical management of complete atrioventricular septal defect: Associations with surgical technique, age, and trisomy 21

“…Although we do not have the data to confirm this, one might speculate that the subgroup of non Trisomy 21 might be more likely to have a comparatively smaller VSD making the Australian type repair more appealing. We corroborated previously noted differences in surgical management with the Australian technique requiring shorter bypass and cross clamp times 16, 18. Although speculative, it is plausible that a surgeon may select the Australian technique as the preferred repair in the youngest and most symptomatic patients to allow the surgery to be completed faster and with less manipulation of the common valve.…”

“…More recently, a modified single patch technique has been described that avoids the use of a patch to close the ventricular septal defect (Australian technique) 6, 7. Although reports comparing the various techniques are limited by era, surgeon, and institutional experience, general equivalence with respect to efficacy has been suggested for short to medium term outcomes 16, 18. Overall, the two patch technique was performed more often (72%) in our series, however, we found considerable variation in type of repair across participating centers.…”

Surgical Interventions of Common Congenital Heart Defects in Dogs: A Comprehensive Review

“…"Australian" one-patch technique [41] : This technique is different from the traditional one-patch technique in details of the surgical maneuver. After testing the competence of the common atrioventricular valve, the valve cleft is repaired using polypropylene sutures.…”

“…A dog with endocardial cushion defect survived free of cardiac symptoms for 6 years and 5 months after two-patch technique repair under cardiopulmonary bypass [40] . The modified "Australian" technique [41] and no patch technique [42] require shorter aortic crossclamp and cardiopulmonary bypass times. Both are novel techniques for the surgical repair of complete endocardial cushion defect in human with good clinical results.…”

“…The mitral valve is sandwiched between the ventricular GoreTex patch and the atrial pericardial patch so that mitral valve laceration and possible dehiscence can be avoided. [41] : After testing the competence of the common atrioventricular valve, a single approximating suture is placed over the septal crest between the superior and inferior leaflets. A Dacron patch is sutured to the middle of the septal crest by 5-0 pledgeted polypropylene sutures.…”