[Total repair of atrioventricular septal defect with tetralogy of Fallot or Fallot's type double outlet right ventricle].

OBJECTIVE

To summarize the experience in total repair of atrioventricular septal defect with tetralogy of Fallot or Fallot's type double outlet right ventricle.

METHODS

Ten patients with atrioventricular septal defect associated with tetralogy of Fallot or Fallot's type double outlet right ventricle underwent repair between June 2000 and September 2002. Atrioventricular septal defect was repaired with a 2-patch technique. The ventricular patch material was dacron artificial vascular patch, autologous pericardium was used to close the ostium of atrial septal defect after repair of the atrioventricular valve. Closure of ventricular septal defect (VSD) necessitated a combined right atrial and right ventricular approach. Each patient underwent an extensive infundibulectomy performed through the right ventriculotomy. If the pulmonary valve was more than 1 mm or 2 mm in diameter, smaller than the normal size, a transannular pericardial patch was used. If abnormal coronary arteries existed in the surface of right ventricular outflow, a homograft was used to connect the right ventricle with pulmonary artery.

RESULTS

There was one death (10%) six months after repair. Two patients were not able to be extubated from ventilator because of residual VSD. After repairing the residual VSD, one patient was extubated from ventilator. The other still wasn't able to be extubated from ventilator due to right diaphragm paralysis. After folding right diaphragm, the patient got stable recovery.

CONCLUSION

Atrioventricular septal defect with tetralogy of Fallot or Fallot's type double outlet right ventricle can be corrected with low mortality. Residual VSD can severely affect recovery. Long-term results need to be followed up.