Background: Although the no-patch technique was the first described surgical treatment for complete atrioventricular canal (CAVC) by Lillihei in 1955, single or double patch techniques, which are more complex, are currently more widely used. We report our initial experience with this simple technique.
Methods: Eight consecutive patients underwent operation using the no-patch technique between April 2007 and August 2008. The CAVC was closed using pledgeted interrupted sutures placed on the right side of the VSD crest, passed through the bridging leaflet and to the facing part of the ostium primum defect, with closure of the left atrioventricular (AV) valve cleft and sliding plasty of the right AV septal leaflet.
Results: The median age was 11 months (4-58 months). The median weight was 5.2 kg (4.4-8.6). The mean VSD size was 8.4±1.8 mm. Trisomy 21 was present in 7 patients. Cross-clamp and cardiopulmonary bypass were a mean of 52±10 and 77±16 minutes. Two patients required concomitant right AV valve annuloplasty. There were no early deaths and all patients were in sinus rhythm. On discharge echocardiogram, no patient presented a significant residual VSD or LVOT obstruction. One patient presented grade II left AV valve regurgitation and grade III right AV valve regurgitation; all others had no or trivial regurgitation. There were no late deaths or reoperations.
Conclusions: Surgical treatment of CAVC using the no-patch technique produces results comparable to single or double patch techniques, while avoiding the use of foreign material. These initial results are promising, but further studies are required.