Methods: retrospective study of 80 consecutive patients operated upon with the diagnosis of CAVC between 1994 and 2006. 39 of them had complete and 41 had incomplete CAVC. For the complete form the single patch technique with autologous was preferentially used. Complete cleft closure was performed if no atypical valvular anomaly precluded it. Follow-up Doppler echocardiographic examinations performed at 1month, 3 months, one year, postoperatively as well as the latest examination (total mean FU 58.3 months for complete and 48.6months for the incomplete AV canals) were reviewed.

Results: Perioperative mortality was 1/39 in the complete and 1/41 in the incomplete forms. Reoperation rate for left AV valve insufficiency (LAVVI) was 3/39 (7.6%) for complete and 1/41 (2.4%) for incomplete forms respectively. In the survivors the pattern of the LAVVI was stable in 44, progressive in 19, regressive in 5 and undulating in 9 patients. From the 4 reoperated patients due to LAVVI (all produced by incomplete cleft closure and successfully reoperated with additional cleft sutures) 3 showed a progressive pattern and one an undulating pattern.

Conclusions: The majority of the patients operated upon with CAVC did not progress to reoperation on LAVVI, showing a stable or regressive pattern of the LAVVI postoperatively. About 25% show a slight worsening over the time, this progression not being associated with any particular identifiable factor. An incomplete cleft closure, which was not perceived as such by the surgeon at the time of the repair, was the single cause of the 4 reoperations.