Abstract 17536: Modified Single Patch Repair of Complete Atrioventricular Septal Defect is Performed More Efficiently with No Detrimental Effect on Left Ventricular Outflow Size and Atrioventricular Valve Coaptation Reserve

Abstract

Objectives: Concerns have been raised about left ventricular outflow tract (LVOT) narrowing and increased left atrioventricular valve regurgitation (LAVV) following atrioventricular septal defect (AVSD) repair with a modified single patch technique. Therefore, we sought to compare the effects of modified single and two patch surgical repair of complete AVSD on the LVOT diameter and the LAVV coaptation.

Methods: We reviewed retrospectively postoperative two-dimensional echocardiograms of all AVSD patients who underwent modified single patch or two-patch repair between 2005 and 2011. We measured leaflet coaptation length and tenting height of the LAVV in the apical 4 chamber view. The LVOT was measured in the long axis view.

Results: Fifty-one patients underwent AVSD repair (single patch n=29, two-patch n=22) with 46 having adequate images for analysis. Five patients were re-operated after single patch repair (3 residual ventricular septal defect (VSD) and LAVV regurgitation, 1 residual VSD and right AVV regurgitation, 1 pacemaker implantation). One patient after two-patch repair had reoperation for a residual VSD. The difference in reoperation rates was not significant (P=0.22). Patient characteristics, LVOT and leaflet findings are summarized in table below.

Conclusions: The modified single patch repair was performed with significantly shorter bypass time and myocardial ischemic time without significant difference in post-operative LVOT diameter or LAVV leaflet coaptation length. Further investigation of reoperation rates may be warranted.