Clinical & Experimental Cardiology
Open Access

Abstract

Repair of Complete Atrioventricular Septal Defects with Tetralogy of Fallot, Double Patch Technique with Augmentation of the Left Atrioventricular Valve: Early Results from a Developing Country Tertiary Cardiac Centre

Waleed I Ibraheem

Background: The association of the Tetralogy of Fallot (TOF) with a Complete Atrioventricular Septal Defect (CAVSD) occurs in 5-10% of hearts with CAVSD. In this paper, we describe the early results of a modification of the double patch technique in which we augment the LAVV leaflet using the patch used for the VSD closure in the repair of CAVSD with TOF.
Patients and Methods: Between 2012 and 2014, 12 consecutive patients with CAVSD associated with TOF underwent complete repair were retrospectively reviewed. A double patch technique with LAVV leaflet augmentation was used in all the patients. Tetralogy of Fallot repair included transannular patch in 11 (65%) patients and valvesparing in 6 (35%) patients.
Results: Mean age was 25 months ± 18.8, 7 males. Mean weight was 25 kg ± 18.8. Mean pulmonary artery annulus z-score was -1.2 ± 2. The mean preoperative RVOT gradient was 74 ± 18 mm Hg. The in-hospital mortality rates were 20% (2 out of 10). Mean ICU STAY time was 4.5 ± 3.5 days. Mean Mechanical ventilation time was 18 hours ± 10.3. Mean Hospital Stay was 12.5 days ± 5. Pulmonary Regurge was mild in 4 patients (40%) and
moderate in the remaining six patients (60%). Postoperative (Left AV Valve Regurge) was mild to moderate in all the corrected patients. Mean follow-up was 10 ± 3.1 months (range 4 to 14 months).
Conclusion: Complete repair with this technique offer an acceptable early outcome regarding mortality, and degree of LAVV regurge.