ANATOMICALLY SOUND, SIMPLIFIED APPROACH TO REPAIR OF COMPLETE ATRIOVENTRICULAR SEPTAL-DEFECT

Background. There are few congenital anomalies of the heart that have benefited more from thorough anatomic analysis than the complex anomal y known as atrioventricular septal defect in the setting of common atr ioventricular junction. Recent advances in understanding the anatomy o f this lesion have led to alternative methods of repairing these defec ts. Methods. The medical records of 21 consecutive patients undergoing repair of complete atrioventricular septal defect have been reviewed. Nine of these patients had a standard one-or two-patch repair, and 12 had direct closure of the ventricular element of the defect. Results. Direct closure resulted in significantly shorter pump and cross-clamp times. Follow-up for an average of 34 months suggests that when direc t closure can be performed, the results are comparable with those of t he more standard technique. Conclusions. Our initial success with this approach is encouraging; however, longer follow-up is required to est ablish whether it will be broadly applicable. (C) 1997 by The Society of Thoracic Surgeons.