Complete atrioventricular canal repair with a decellularized porcine small intestinal submucosa patch |
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Authors: | Eliana Al Haddad Damien J LaPar Jeffrey Dayton Elizabeth H Stephens Emile Bacha |
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Institution: | 1.Pediatric Cardiac Surgery, Department
of Surgery, Morgan Stanley Children’s
Hospital, Columbia University Medical
Center, New York, New York
2 Division of Pediatric Cardiology, NewYork‐
Presbyterian/Weill Cornell Medical Center,
New York, New York |
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Abstract: | Background: Congenital heart defects affect nearly 1% of all children born per year
in the United States, and complete atrioventricular canal (CAVC) accounts for 2%‐9%.
While several patch materials have been used for septal defect closure during CAVC
repair, clear superiority of one material over another has yet to be established.
Methods: A retrospective review of clinical outcomes following CAVC repair at
Morgan Stanley Children’s Hospital/Columbia University was performed on opera‐
tions conducted from March 2010 to September 2017. Univariate and Kaplan‐Meir
survival analyses were utilized to evaluate primary outcomes of interest following
CAVC repair in the modern surgical era.
Results: A total of 73 patients were analyzed, with an average operative age of
22 weeks. The majority (71%) of the patients underwent a 2‐patch repair. A CorMatrix
patch was used for ventricular septal defect(VSD) closure in 77% of the patients,
and/or in 75% of atrial septal defect closures. There was one in‐hospital mortality
(1.4%) due to respiratory failure. One patient required a pacemaker. At mid‐term fol‐
low‐up (1.6 years), a total of 7 patients required 8 reoperations due to cardiac‐related
indications, including 5 for left atrioventricular valve (LAVV) repair, 1 for LAVV re‐
placement, and 2 isolated residual VSDs.
Conclusion: A standardized repair for CAVC results in excellent outcomes in the cur‐
rent era, with low rates of reoperations. CorMatrix for the closure of CAVC has
proven to produce good results with equivalent outcomes to other patch materials.
Its ease of use and pliability make it an attractive alternative for consideration. |
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Keywords: | atrioventricular septal defect common atrioventricular canal defect congenital heart surgery CorMatrix patch |
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