Why the study?
Does total surgical correction using the 2-patch technique provide safe and effective outcomes in children with complete atrioventricular septal defect associated with tetralogy of Fallot?
Does total surgical correction using the 2-patch technique provide safe and effective outcomes in children with complete atrioventricular septal defect associated with tetralogy of Fallot?
Total surgical correction of complete AVSD with TOF using the 2-patch technique is feasible and yields good mid-term outcomes without the need for reoperation in carefully selected patients weighing around 8 kg with a PA index of 200 or more.
Complete atrioventricular septal defect (AVSD) associated with tetralogy of Fallot is a rare condition that still has problems in the postoperative period. The authors report their surgical experiences over the past 10 years. Nine children underwent total correction. The defect was repaired by the 2-patch technique and the ATrioventricular valve was reconstructed by suturing the cleft and annuloplasty. A transannular right ventricular outflow patch was used in 5 patients. All patients had Down syndrome and a free-floating superior bridging lEAflet. One patient died from cardiac failure. Although there was no reoperation or death in the late postoperative periods, mild mitral regurgitation occurred in 4 patients and there was moderate or severe pulmonary regurgitation in 2 patients. All survivors currently have no critical symptoms in their daily lives. With the standard of patient selection used, the optimal body weight was around 8 kg and PA index was 200 or more. Right ventriculotomy provided a better view for complete closure of the ventricular septal defect (VSD). In order to avoid re-regurgitation of the atrioventricular valve, the 2-patch technique is the most suitable procedure for total repair.
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Okada et al. (1999) studied this question.
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