Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Outcomes after repair of complete atrioventricular canal with a modified single-patch technique: a retrospective study

  • George Samanidis (Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center) ;
  • Konstantinos Kostopanagiotou (Department of Thoracic Surgery, Attikon University Hospital of Athens) ;
  • Meletios Kanakis (Department of Paediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center) ;
  • Georgios Kourelis (Paediatric Cardiac and Adult Congenital Heart Disease Intensive Care Unit, Onassis Cardiac Surgery Center) ;
  • Kyriaki Kolovou (Department of Cardiac Surgery Intensive Care, Onassis Cardiac Surgery Center) ;
  • Georgios Vagenakis (Department of Paediatric Cardiology and Adult Congenital Heart Disease, Onassis Cardiac Surgery Center) ;
  • Dimitrios Bobos (Department of Paediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center) ;
  • Nicholas Giannopoulos (Department of Paediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center)
  • Received : 2022.10.17
  • Accepted : 2022.12.09
  • Published : 2023.04.30
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Abstract

Background: This study aimed to present the short- and midterm outcomes after complete atrioventricular canal defect (CAVC) repair using a single-patch technique. Methods: This study included 30 children who underwent surgical correction of the CAVC using a single-patch technique. Results: The median age of the patients was 5.7 months (interquartile range [IQR], 5.0-7.5 months), and 23 patients (76.7%) had type A CAVC. Fourteen patients (46.7%) were female and 17 (56.7%) had been diagnosed with Down syndrome. The in-hospital mortality rate was 0%. No deaths were observed during a median follow-up of 4 years (IQR, 3.5-5.0 years). Patients without Down syndrome were associated with late moderate mitral regurgitation (MR) (p=0.02). Late MR less than moderate degree was observed in 96.6%, 78.5%, and 50% of patients after 2, 4, and 5 years of follow-up, respectively, while late tricuspid valve regurgitation less than moderate degree was observed in 96.7%, 85.9%, and 59.0% of patients after 2, 4, and 6 years of follow-up, respectively. After a median follow-up of 4 years, only one patient had required surgical repair of a left ventricular outflow tract obstruction, which occurred 26 months after the first operation. Multivariable logistic regression analysis adjusted for the type of CAVC, sex, Down syndrome, age, and weight revealed that the absence of Down syndrome was a risk factor for late moderate MR (MR-2) (odds ratio, 0.05; 95% confidence interval, 0.006-0.50; p=0.01). Conclusion: A single-patch technique for CAVC surgical repair is a safe method with acceptable short- and midterm results.

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References

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