[Surgical correction of complete atrioventricular septal defect with tetralogy of Fallot].

OBJECTIVE

To report the surgical correction of complete atrioventricular septal defect with tetralogy of Fallot (AVSD-TOF).

METHODS

Six consecutive patients aged 3 - 9 years underwent correction of complete AVSD-TOF. The two-patch technique for atrioventricular septal defect was used. The ventricular septal defect was closed through a right ventriculotomy and right atriotomy in each case. The commissure between the superior and inferior bridging leaflets of the left portion of the common atrioventricular valve was closed in each patient. RVOT obstruction was relieved by a transannular autologous pericardium with monocuspid valve.

RESULTS

Postoperative complications included respiratory failure in 1 patient, low cardiac output syndrome in 1, and MOF in 1. There was one mortality because of MOF in the early postoperative period. Five survivors were followed up from 6 months to 5.5 years (mean 2.3 years). There was no late mortality and only one patient had mild left atrioventricular valve regurgitation. NYHA cardiac function was class I in 4 patients and class II in 1.

CONCLUSIONS

AVSD-TOF can be corrected using the two-patch technique and closure of the ventricular septal defect through a combined approach using a right ventriculotomy and right atriotomy. Routine closure of the commissure of the left portion of the atrioventricular valve results in a low incidence of regurgitation. Good functional result can be achieved in most patients postoperatively.