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Modified Single Repair Technique for Complete Atrioventricular Septal Defect: A Propensity Score Matching Analysis

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Abstract

There were controversies about the priority of modified single patch (MSP) technique compared with two-patch (TP) technique for patients with complete atrioventricular septal defect (CAVSD). From 2002 to 2013, patients who diagnosed as balanced CAVSD in our institution were retrospectively included. Patients with unbalanced ventricles or associated anomalies were excluded. The primary endpoint was all-cause mortality and the secondary endpoint consist of left atrioventricular dysfunction or left atrioventricular outflow tract obstruction (LVOTO). A total of 74 patients underwent MSP repair and 102 patients underwent TP repair. After 1:1 propensity matching, there were 46 Rastelli type A CAVSD patients in each group. Patients in MSP group had shorter cardiopulmonary bypass time [median (interquartile range) 73.5 (65.5–95.0) versus 105.0 (88.8–130.0) min, P < 0.001] and aortic cross-clamp time [105.5 (90.0–128.0) versus 143.0 (122.0–184.0) min, P < 0.001]. In total, the primary endpoint occurred in 12 patients, including 2/46 (4.3%) in MSP group and 10/46 (21.7%) in TP group. That 1-year, 3-year, 5-year survival rate can be calculated as 95.6%, 95.6%, 95.6% in MSP group and 92.6%, 80.4%, 78.2% in TP group, P = 0.015. No significant statistical difference found for the secondary endpoints that 7/46 (15.2%) patients occurred moderate or severe LAVVR in MSP group versus 11/46 (23.9%) patients in TP group, P = 0.293. No LVOTO occurred in both groups. Besides the simplicity of technique, MSP technique may be safer.

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Abbreviations

CAVSD:

Complete atrioventricular septal defect

LVOTO:

Left ventricular outflow tract obstruction

VSD:

Ventricular septal defect

LAVVR:

Left atrioventricular valve regurgitation

RAVVR:

Right atrioventricular valve regurgitation

PDA:

Patent ductus arteriosus

ECMO:

Extracorporeal membrane oxygenation

LVEF:

Left ventricular ejection fraction

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Funding

This work was supported by National Key R&D Program of China [2017YFC1308100] and National Natural Science Foundation of China [81570289].

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Authors and Affiliations

  1. Pediatric Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037, The People’s Republic of China

    Guanxi Wang, Kai Ma, Zhongdong Hua, Sen Zhang, Lei Qi, Yang Yang, Zicong Feng, Hao Zhang & Shoujun Li

  2. Department of Echocardiography, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, The People’s Republic of China

    Kunjing Pang

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  1. Guanxi Wang
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  2. Kai Ma
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Correspondence to Shoujun Li.

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Wang, G., Ma, K., Pang, K. et al. Modified Single Repair Technique for Complete Atrioventricular Septal Defect: A Propensity Score Matching Analysis. Pediatr Cardiol 41, 615–623 (2020). https://doi.org/10.1007/s00246-020-02292-4

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