Journal of Developmental Medicine(Electronic Version)  2022, Vol. 10 Issue (5): 373-377 DOI: 10.3969/j.issn.2095-5340.2022.05.008 |
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| Compare of two surgical methods for complete atrioventricular canal in infants |
| Wang Gang, Zhou Gengxu, Wang Hui, et al
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Beijing Key Laboratory of PediatricOrgan Failure, National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology,Institute of Pediatrics, the Seventh Medical Center of PLA General Hospital, Faculty of Pediatrics, theChinese PLA General Hospital, Beijing 100700, China
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Abstract 【Abstract】 Objective To compare the clinical effect of modified single-patch technique and twopatch
technique for complete atrioventricular canal (CAVC) in infants. Method From January 2011 toJanuary 2019, the clinical data of 52 children who underwent CAVC correction in the Faculty of Pediatrics,the Chinese PLA General Hospital were retrospectively analyzed. The cases were divided into two groups:
modified single-patch technique group (n=28) and two-patch technique group (n=24). The preoperative basicinformation, surgical treatment effect and long-term prognosis were compared between the two groupsEchocardiography and electrocardiogram were reexamined at 3, 6, and 12 months after operation, andthereafter echocardiography was reexamined once a year. The long-term prognosis and reoperation
were followed up. Statistical methods performed by t-test, χ2 test or Fisher exact probabilitymethod. Result Fourteen cases (26.9%) were complicated with Down syndrome and 20 cases (38.5%)were complicated with pulmonary hypertension. Other cardiac malformations included patent ductusarteriosus in 11 cases, secondary hole atrial septal defect in 28 cases, and persistent left superior vena cavain 5 cases. Preoperative common Trioventricular regurgitation was mild in 20 cases, moderate in 25 casesand severe in 7 cases. The aortic cross-clamp time [(92±29) vs (119±35) min] and cardiopulmonary bypass
time [(68±23) vs (88±28)min] in two groups , the modified single-patch method group was lower than thosein the two-patch technique group, the difference were statistically significant (t=3.124, 3.352, P<0.05). Twopatients died early after operation (within 30 days after operation), and the mortality rate was 3.8% (2/52).The early postoperative mortality was 3.6% (1/28) in the modified single-slice group and 4.2% (1/24) in thetwo-patch technique group, and there were no significant difference (P=1.0001). Three cases were lost tofollow-up, and the follow-up rate was 94.0%. The average follow-up time was 22 months (6-70 months).There were no long-term deaths during follow-up. Three patients with residual shunt of ventricular septaldefect (defect <3 mm) were followed up. One case in each group underwent reoperation due to severe mitralregurgitation. Conclusion The effect of CAVC correction in infants is satisfactory. The modified singlepatchmethod can simplify the operation and shorten the operation time. There is no significant difference invalve repair between the two methods.
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Received: 13 July 2021
Published: 30 September 2022
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