Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-10T08:14:13.529Z Has data issue: false hasContentIssue false
  • English
  • Français

Surgical repair of atrioventricular septal defect with common atrioventricular junction when associated with tetralogy of Fallot or double outlet right ventricle

Published online by Cambridge University Press:  13 October 2006

Christo I. Tchervenkov ,
Samantha Hill ,
Danny Del Duca  and
Stephen Korkola
Christo I. Tchervenkov
Affiliation:
Division of Cardiovascular Surgery, Montreal Children's Hospital of the McGill University Health Center, McGill University, Montreal, Québec, Canada
Samantha Hill
Affiliation:
Division of Cardiovascular Surgery, Montreal Children's Hospital of the McGill University Health Center, McGill University, Montreal, Québec, Canada
Danny Del Duca
Affiliation:
Division of Cardiovascular Surgery, Montreal Children's Hospital of the McGill University Health Center, McGill University, Montreal, Québec, Canada
Stephen Korkola
Affiliation:
Regina General Hospital, Regina, Saskatchewan, Canada
Get access Rights & Permissions [Opens in a new window]

Abstract

The association of atrioventricular septal defect with common atrioventricular junction and malformations of the ventricular outflow tracts presents a significant challenge for the surgeon. In the most common of these, the association with tetralogy of Fallot, several surgical techniques have been described, and shown to deliver excellent results.1–10 On the other hand, in the setting of more extreme malformations, such as double-outlet right ventricle, discordant ventriculo-arterial connections, or common arterial trunk, albeit rare lesions, the combination presents a more formidable surgical challenge, as evidenced by the few reports of successful repair of these lesions. This challenge is both physiological, when dealing with a very sick neonate or infant, as well as anatomical in terms of the complexity of the malformation and the ability to achieve a successful biventricular repair. Our goal in this review is to discuss the surgical treatment in the setting of tetralogy of Fallot and double outlet right ventricle, with emphasis on biventricular repair.

Keywords

Common atrioventricular junctionventriculo-arterial connectionscongenital heart disease
Type
The Atrioventricular Valves
Information
Cardiology in the Young , Volume 16 , Supplement S3: Controversies and Challenges of the Atrioventricular Junctions and Other Challenges Facing Paediatric Cardiovascular Practitioners and their Patients , September 2006 , pp. 59 - 64
Copyright
© 2006 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Pacifico AD, Ricchi A, Bargaron Jr LM, Colvin EC, Kirklin JW, Kirklin JK. Corrective repair of complete atrioventricular canal defects and major associated cardiac anomalies. Ann Thorac Surg 1988; 46: 645–651.Google Scholar
Vargas FJ, Coto ED, Mayer Jr JE, et al. Complete atrioventricular canal and tetralogy of Fallot: Surgical considerations. Ann Thorac Surg 1986; 42: 258.Google Scholar
Ilbawi M, Cua C, Deleon S, et al. Repair of complete atrioventricular septal defect with tetralogy of Fallot. Ann Thorac Surg 1990; 50: 407–412.Google Scholar
Alonso J, Nunez P, Perez de Leon J, et al. Complete atrioventricular canal and tetralogy of Fallot: Surgical management. Eur J Cardiothorac Surg 1990; 4: 297–299.Google Scholar
Gatzoulis MA, Shore D, Yacoub M, Shinebourne EA. Complete atrioventricular septal defect with tetralogy of Fallot: Diagnosis and management. Br Heart J 1994; 71: 579–583.Google Scholar
Karl T. Atrioventricular septal defect with tetralogy of Fallot or double-outlet right ventricle: Surgical Considerations. Semin Thorac Cardiovasc Surg 1997; 9: 26–34.Google Scholar
McElhinney DB, Reddy VM, Silverman NH, Brook MM, Hanley FL. Atrioventricular septal defect with common valvular orifice and tetralogy of Fallot revisited: Making a case for primary repair in infancy. Cardiol Young 1998; 8: 455–461.Google Scholar
Najm HK, Van Arsdell GS, Watzka S, Hornberger L, Coles JG, Williams WG. Primary repair is superior to initial palliation in children with atrioventricular septal defect and tetralogy of Fallot. J Thorac Cardiovasc Surg 1998; 116: 905–913.Google Scholar
O'Blenes SB, Ross DB, Nanton MA, Murphy DA. Atrioventricular septal defect with tetralogy of Fallot: results of surgical correction. Ann Thorac Surg 1998; 66: 2: 2078–2082.Google Scholar
Schmid FX, Kampmann C, Hake U, Choi YH, Wipperman F, Oelert H. Complete atrioventricular septal defect associated with tetralogy of Fallot. Favourable outcome of transarterial transpulmonary repair. J Cardiovasc Surg (Torino) 2000; 41: 17–21.Google Scholar
Bharati S, Kirklin JW, McAllister HA, Lev M. The surgical anatomy of common atrioventricular orifice associated with tetralogy of Fallot, double-outlet right ventricle and complete regular transposition. Circulation 1980; 61: 142–149.Google Scholar
Castaneda AR, Jones RA, Mayer JE Jr, Hanley FL. Atrioventricular canal defect. In: Castaneda AR, Jonas RA, Mayer Jr JE, Hanley FL (eds). Cardiac surgery of the neonate and infant. W.B. Saunders Co, Philadelphia, 1994, pp 167–186.
Van Praagh S, Davidoff A, Chin A, Shiel FS, Reynolds J, Van Praagh R. Double-outlet right ventricle: Anatomic types and developmental implications based on a study of 101 autopsied cases. Coeur 1982; 13: 389–440.Google Scholar
Sridaromont S, Feldt RH, Ritter DG, Davis GD, McGoon DC, Edwards JE. Double-outlet right ventricle associated with persistent common atrioventricular canal. Circulation 1975; 52: 933–942.Google Scholar
Toussaint M, Planche C, Graff WC, Royon M, Ribiere M. Double-outlet right ventricle associated with common atrioventricular canal: Report of nine anatomic specimens. JACC 1986; 8: 396–401.Google Scholar
Pacifico AD, Kirklin JW, Bargeron LM. Repair of complete atrioventricular cnal associated with tetralogy of Fallot or double-outlet right ventricle: report of 10 patients. Ann Thorac Surg 1980; 29: 351–356.Google Scholar
Guo-wei H, Mee RBB. Complete atrioventricular canal associated with tetralogy of Fallot or double-outlet right ventricle and right ventricular outflow tract obstruction: A report of successful surgical treatment. Ann Thorac Surg 1986; 41: 612–615.Google Scholar
Imamura M, Drummond-Webb JJ, Sarris JE, Murphy DJ, Mee RBB. Double-outlet right ventricle with complete atrioventricular canal. Ann Thorac Surg 1998; 66: 942–944.Google Scholar
Danielson GK, Tabry IF, Ritter DG, Maloney JD. Successful repair of double-outlet right ventricle, complete atrioventricular canal, and atrioventricular discordance associated with dextrocardia and pulmonary stenosis. Thorac Cardiovasc Surg 1978; 76: 710–717.Google Scholar
Russo P, Danielson GK, Puga FJ, McGoon DC, Humes R. Modified Fontan procedure for biventricular hearts with complex forms of double-outlet right ventricle. Circulation 1988; 78: 20–25.Google Scholar
Tchervenkov CI, Korkola SJ, Beland MJ. Single-stage anatomical repair of complete atrioventricular canal, double-outlet right ventricle and cor-triatriatum using ventricular septal defect translocation. Ann Thorac Surg 2002; 73: 1317–1320.Google Scholar
Boesen I. Complete transposition of the great vessels. Importance of septal defects and patent ductus arteriosus. Circulation 1963; 28: 885–892.Google Scholar
Shaher RM. Complete transposition of the great vessels. Academic Press, Inc., New York, 1973, p 152.
Roughneen P, Mahmoudian MH, Ott DA. Concomitant repair of complete atrioventricular canal defect and transposition of the great arteries in an infant. Cardiovasc Surg 1995; 3: 78–80.Google Scholar
Katogi T, Aeba R, Tsutsumi K, Lino Y, Hashizume K, Kawada S. Primary repair of complete transposition of the great arteries with complete atrioventricular septal defect. Jpn J Thorac Cardiovasc Surg 2000; 48: 388–390.Google Scholar
Sakamoto K, Galletti L, Touchot A, Piot JD, Bruniaux J, Planché C. Two-stage correction of transposition of the great arteries with complete atrioventricular canal. Ann Thorac Surg 1998; 65: 250–252.Google Scholar
Kumar N, Prabhkar G, Wilson N, Al Halees Z, Duran CMG. Correction of transposition of the great arteries with atrioventricular septal defect. Ann Thorac Surg 1992; 54: 989–990.Google Scholar
Alfieri O, Plokker M. Repair of common atrioventricular canal associated with transposition of the great arteries and left ventricular outflow tract obstruction. J Thorac Cardiovasc Surg 1982; 84: 872–875.Google Scholar
Gonzalez-Lavin L, Blair TC, Chi S, Sparrow AW. Orthoterminal correction of coexisting d-transposition of the great arteries, subpulmonary stenosis, and a complete form of atrioventricular canal. J Thorac Cardiovasc Surg 1977; 73: 694–698.Google Scholar
Sousa-Uva M, Serraf A, Cloez JL, et al. Repair of truncus arteriosus and complete atrioventricular canal defect. J Thorac Cardiovasc Surg 1994; 108; 385–387.Google Scholar
Conte S, Jensen T, Jacobsen JR, Joyce FS, Lauridsen P, Pettersson G. One-stage repair of truncus arteriosus, CAVC, and TAPVC. Ann Thorac Surg 1997; 63: 781–783.Google Scholar