Modified two-patch repair with left atrioventricular valve augmentation for complete atrioventricular septal defect: a novel modification to an older concept

Repair of complete atrioventricular septal defects continues to be a challenge. Several techniques have been described such as the single-patch, the modified single-patch and the two-patch technique. Each has its own pros and cons, and no technique is free from reoperation. Routine augmentation of the left atrioventricular valve during the repair has also been proposed; however, a repeat operation for recurrent left atrioventricular regurgitation continues to be a major concern. In this report, we describe a new strategy for the repair of a complete atrioventricular septal defect that combines the basics of several of the previously described techniques, eliminates some of the anatomical factors behind future left ventricular outflow tract obstruction and may improve competence of the left atrioventricular valve, and has the potential of decreasing the reoperation rate on both the left atrioventricular valve and the left ventricular outflow tract.