Yildirim Ozgur, Avsar Mustafa, Ozyuksel Arda, Akdemir Mehmet, Zeybek Cenap, Demiroluk Sener, Bilal Mehmet Salih
Department of Cardiovascular Surgery, Medicana International Hospital, Istanbul, Turkey.
Department of Cardiovascular Surgery, Medipol University, Istanbul, Turkey.
J Card Surg. 2015 Jul;30(7):595-600. doi: 10.1111/jocs.12557. Epub 2015 May 5.
We present our single center results of two commonly used surgical techniques, the modified single-patch and double-patch technique for the repair of the complete atrioventricular septal defect.
We enrolled 49 patients with complete atrioventricular septal defect who were operated by a single surgeon between 2004 and 2014. The modified single-patch technique was performed in 32 cases (group S), whereas the defect was repaired with the double-patch technique in 17 patients (group D).
The mean age at the time of operation was 7.7 ± 8.6 (range 1-48) months and 9.9 ± 12.5 (range 1.5-48) months, in groups S and D, respectively. Mean body weight was 6.7 ± 3 (range 3.5-15.5) kilograms and 7.2 ± 3.8 (range 4.3-14.5) kilograms in groups S and D, respectively. Cross-clamp and cardiopulmonary bypass times were shorter in the modified single-patch group (65.6 ± 16.3 vs. 98.7 ± 19.8 minutes, p = 0.0001; 88.9 ± 23.3 vs. 128.9 ± 28.0 minutes, p = 0.0001). Postoperative atrioventricular valve function was improved in both groups. Mean follow-up period was 4.4 ± 3.2 (range 1.2-9.9) years. One patient in each group underwent reoperation for left atrioventricular valve insufficiency. We encountered two early and one late mortalities in modified single-patch group. One early mortality was experienced in the unmodified group.
The modified single-patch and two-patch techniques have comparable results; however, the modified single-patch technique is performed with significantly shorter cross-clamp and cardiopulmonary bypass times, therefore we have adopted this technique on a routine basis for the treatment of the complete atrioventricular septal defect in our institute.
我们展示了两种常用手术技术（改良单片修补术和双片修补术）用于完全性房室间隔缺损修复的单中心研究结果。
我们纳入了49例在2004年至2014年间由同一位外科医生进行手术的完全性房室间隔缺损患者。32例患者采用改良单片修补术（S组），17例患者采用双片修补术修复缺损（D组）。
S组和D组手术时的平均年龄分别为7.7±8.6（范围1 - 48）个月和9.9±12.5（范围1.5 - 48）个月。S组和D组的平均体重分别为6.7±3（范围3.5 - 15.5）千克和7.2±3.8（范围4.3 - 14.5）千克。改良单片修补组的主动脉阻断和体外循环时间更短（65.6±16.3对98.7±19.8分钟，p = 0.0001；88.9±23.3对128.9±28.0分钟，p = 0.0001）。两组术后房室瓣功能均得到改善。平均随访期为4.4±3.2（范围1.2 - 9.9）年。每组各有1例患者因左房室瓣关闭不全接受再次手术。改良单片修补组出现2例早期死亡和1例晚期死亡。未改良组出现1例早期死亡。
改良单片修补术和双片修补术效果相当；然而，改良单片修补术的主动脉阻断和体外循环时间明显更短，因此我们所在机构已将该技术常规用于完全性房室间隔缺损的治疗。
