Atrioventricular canal defect: Two-patch repair and tricuspidization of the mitral valve

Between November 1978 and May 1991, a two-patch repair with tricuspidization of the left atrioventricular valve was performed in 104 patients with complete atrioventricular canal defect. Mean age was 12 months for the 68 patients who underwent primary repair and 22 months for the 36 patients who had previous pulmonary artery banding. Eleven patients died within 30 days of operation and 4 died late. Reoperation was carried out in 2 patients. Eighty-six patients were in sinus rhythm after operation. One patient required a permanent pacemaker for complete heart block. Follow-up data for 1 to 13 years are available in 80 of 89 survivors (90%). Actuarial survival at 13 years is 81% and event-free survival is 92%. Seventy-six patients are in New York Heart Association class I and 4 in class II. Postoperative echocardiogram of these patients showed minimal or no mitral regurgitation. The advantages of this technique are preservation of valve integrity, durable mitral valve repair, and rare reoperation or heart block even in younger patients.