Repair of conplete atrioventricular septal defects without division of the bridging leaflets using the double-patch technique in patients weighing less than 5 kg

Abstract

Objective To evaluate the therapeutic effect of non-surgical division of the bridging leaflets using the double-patch technique on patients with complete atrioventricular septal defect (CAVSD)weighing less than 5 kg at operations.Methods From January 2002 to June 2007,15 consecutive patients with CAVSD underwent primary repair using a two-patch technique with no surgical division of the bridging leaflets,with the mean age of 3.4±0.7 months(ranging from 2 to 6 months)and with the mean body weight of 4.4±0.2 kg(ranging from 3.75 to 5.0 kg).Preoperative echocardiographic atrioventricular valve regurgitation was mild in 2 cases,moderate in 10 and severe in 3.All patients were type A according to the Rastelli classification.Two patients(13.3%)got the complication of Down's syndrome.Results One patient died of severe left atrioventricular valve regurgitation (LAVVR).One patient had temporary hemoglobinuria,and 1 patient had I°atrioventricular block.None got complete atrioventricular block.The mean follow-up period was 1.92±0.25 years(ranging from 0.5 to 3 years).Follow-up electrocardiography showed that all patients remained in sinus rhythrm Two cases had mild LAVVR,and 2 cases had mild to moderate LAVVR.No patients got residual ventricular septal defect and left ventricular outflow tract obstruction by cross-sectional echocardiography.Conclusions We may conclude that repair of CAVSD with no surgical division of the bridging leaflets can be carried out successfully in patients weighing less than 5 kg. Key words: Heart septal defects; atrial; Heart septal defects,ventricular; Heart diseases; congenital