Key result
Adding posterior annuloplasty to cleft closure in AV canal repair is linked to lower short-term mortality.
Why the study?
The optimal timing, surgical technique, and the influence of Trisomy 21 on the outcome of surgical repair of complete atrioventricular canal defect remained uncertain.
Cohort (n=70)
No
p-value: p=0.002
Hypothesis-generating for adjunctive posterior annuloplasty in complete AV canal repair; prospective trials needed before practice change.
Background: The optimal timing, surgical technique and the influence of Trisomy 21 on outcome of surgical repair of Complete Atrio-Ventricular Canal Defect (CAVC) remain uncertain. We reviewed our experience in repair of CAVC to identify the influence of these factors on operative outcome. Methods: A prospective study included 70 patients who underwent repair of CAVC at our institute between July 2016 to October 2019. Primary endpoint was mortality and secondary endpoint was degree of left atrio‐ventricular valve (LAVV) regurgitation.Results: No significant difference noted between patients operated on, at the first 6 months of age versus later, regarding mortality or LAVV regurgitation. Surgical repair by modified single patch technique showed significant reduction in bypass time (71.13 ± 13.507 min vs 99.19 ± 27.092 min, P value =0.001). Comparison to closure of cleft only, posterior annuloplasty used for repair of LAVV resulted in significant reduction in the occurrence of post-operative valve regurgitation during the early period (LAVV 2+ 43 % vs 7 %, P value=0.03) and at 6 months of follow up (LAVV 2+ 35.4 % vs 0 %, P value=0.01) respectively.Conclusion: Early intervention, in the first 6 months in patients with CAVC by surgical repair gives comparable acceptable results to later repair; Trisomy 21 was not found to be a risk factor for early intervention. Repair of common AV valve by cleft closure with posterior LAVV annuloplasty showed better results with significant decrease in postoperative LAVV regurgitation and early mortality in comparison to closure of cleft only.
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Azzab et al. (2021) conducted a cohort in Complete Atrioventricular Canal Defect (n=70). Posterior annuloplasty vs. Closure of cleft only was evaluated on Mortality (p=0.002). The addition of posterior annuloplasty to cleft closure during complete atrioventricular canal defect repair significantly reduced short-term mortality (p=0.002) compared to cleft closure alone.
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