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A Novel Technique for Repair of Complete Atrioventricular Canal Defect: The Central Patch Technique.
MedLine Citation:
PMID:  24958047     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Two-patch, single-patch, and modified single-patch repairs are accepted techniques for repair of complete atrioventricular (AV) canal defects. We propose a novel, alternative technique: the central patch technique.
METHODS: For the central patch technique, the superior and inferior bridging leaflets are attached with simple sutures to the right and left of their coaptation point. Both bridging leaflets are incised along a line above the ventricular crest, similar to a traditional single-patch technique. An oval pericardial patch is sewn to the central defect created in the AV valve tissue. Interrupted, horizontal mattress sutures are placed along the ventricular crest, through the midline of the central patch and through the edge of the atrial septal defect (ASD) patch. Tying the sutures simultaneously closes the ventricular septal defect (VSD) and secures the ASD patch to the ventricular crest. Repair of the left AV valve and ASD closure are performed in the routine fashion.
RESULTS: Five patients underwent the central patch technique repair of complete AV canal defect. Weight was 4.8 to 6.3 kg; age was four to eight months. Cardiopulmonary bypass and myocardial times averaged 137 minutes and 109 minutes, respectively. No patient had more than mild left AV valve regurgitation or trivial residual VSD at completion of repair. No patient developed left ventricular outflow tract obstruction.
CONCLUSION: The central patch technique is applicable to all forms of complete AV canal defect. Subjectively, it offers technical advantages compared to standard techniques and may result in a shorter learning curve for junior congenital heart surgeons. Results are preliminary but are consistent with standard techniques.
Authors:
William I Douglas; Unnati Doshi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-23
Journal Detail:
Title:  World journal for pediatric & congenital heart surgery     Volume:  5     ISSN:  2150-136X     ISO Abbreviation:  World J Pediatr Congenit Heart Surg     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101518415     Medline TA:  World J Pediatr Congenit Heart Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  434-439     Citation Subset:  -    
Copyright Information:
© The Author(s) 2014.
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