Case Report: A Third Patch as a Saviour in an Unsuccessful Complete Atrioventricular Septal Defect Repair


ŞİŞLİ E., KÖŞGER P.

Congenital Heart Disease, vol.20, no.4, pp.531-537, 2025 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 20 Issue: 4
  • Publication Date: 2025
  • Doi Number: 10.32604/chd.2025.067271
  • Journal Name: Congenital Heart Disease
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE
  • Page Numbers: pp.531-537
  • Keywords: cardiac surgical procedures, cardiac valve annuloplasty, Complete atrioventricular septal defect, mitral valve regurgitation, tricuspid valve regurgitation
  • Eskisehir Osmangazi University Affiliated: Yes

Abstract

Residual atrioventricular valve regurgitation after correction of complete atrioventricular septal defect (cAVSD) is still not ideal. As a modification of the double-patch method, our technique comprises a suture-bite-wide strip of a third patch that is incorporated to the upper margin of the left side of the ventricular septal defect (VSD) patch. This third patch counteracts not only the valvular tissue loss caused by the suture bites but also the rightward displacement of the VSD patch in a bulged fashion that occurs with increased left ventricular pressure after weaning from cardiopulmonary bypass. This unfavorable outcome was addressed with the current technique through augmentation of the left-sided bridging leaflets serving to prevent the separation of them from their corresponding mural leaflets. The concept was applied in two cases with Down syndrome aged 5 months and 6 months, respectively, as a rescue procedure in the same session just after a failed cAVSD repair. Since the immediate- and short-term outcomes of the atrioventricular valves in regard to regurgitation are satisfying, we believe that the technique proposed herein holds promise for the future in terms of tackling residual atrioventricular valve regurgitation.