A surgical approach of an unusual variant of complete atrioventricular defect; A case report

Hamad Qabha,Mohannad Dawary,Mohamad Khouqeer,Tariq Alanazi,Fareed Khouqeer

doi:10.1186/s43057-021-00057-0

Abstract

BackgroundComplete atrioventricular canal is a congenital heart defect that is characterized by an atrial septal defect, ventricular septal defect, and a common atrioventricular valve. Standard surgical techniques for repairing complete atrioventricular canal defect mainly includes repairing the defect with a single patch, a double patch, or with the modified single patch technique.Case presentationThis paper presents a novel surgical repair technique of an unusual anatomical presentation for a complete atrioventricular canal defect in a patient with Down syndrome.ConclusionsUnusual anatomical variant for congenital heart defects occurs frequently, which gives surgeons real opportunities to innovate surgical approaches. This patient was an example of an unusual anatomical presentation for complete atrioventricular canal, and the surgical technique used for this patient was novel. Follow up for these patients is mandatory for long term results.

Highlights

Complete atrioventricular canal is a congenital heart defect that is characterized by an atrial septal defect, ventricular septal defect, and a common atrioventricular valve
Complete atrioventricular canal (CAVC) is a congenital heart defect that is characterized by an ostium primum atrial septal defect (ASD), a common atrioventricular (AV) valve, and inlet ventricular septal defect (VSD) [2]
CAVC accounts for 3.4% of all congenital heart defects and more than 50% of congenital heart defects in Down syndrome children [4]

Summary

Conclusions

Standard surgical techniques for CAVC mainly include the following: single patch, double patch, and the modified single patch repair [8]. Anatomic presentation of CAVC has variable malformations and defects in the heart, and these malformations may affect ASD, VSD, and a common AV valve junction that may contain variable attachment to the septum [5, 12]. There are anatomical variations of this congenital anomaly, in this case, the patient was presented at the surgery with the superior bridging leaflet attached by a membranous tissue to the crest of the ventricular septum anteriorly with the small VSD on the inferior aspect. The inferior bridging leaflet is entirely adherent to the crest of the ventricular septum Because of this unusual presentation, the VSD was closed by sutures wherein classical repair techniques of this congenital defect the VSD would be closed by using a patch [14].

Background

Findings