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J Thorac Cardiovasc Surg 2004;127:1678-1681
© 2004 The American Association for Thoracic Surgery

Surgery for congenital heart disease

Direct closure of the septum primum in atrioventricular canal defects

^a Cardiovascular Surgery, Zurich, Switzerland
^b Anesthesia, University Hospital Zurich, Zurich, Switzerland

Received for publication August 20, 2003; revisions received September 26, 2003; accepted for publication October 7, 2003.

^* Address for reprints: René Prêtre, MD, Clinic for Cardiovascular Surgery, University Hospital Zurich, Ramistrasse 100, Zurich, CH-8091 Switzerland
rene.pretre{at}usz.ch

OBJECTIVE: The objective of this study was to assess the safety of directly closing the septum primum during the correction of atrioventricular canal defects.

METHODS: We performed a retrospective analysis of our experience with direct closure of the septum primum during the repair of atrioventricular canal defect. The series consisted of 28 consecutive patients presenting with a partial (15 patients) and complete (13 patients) atrioventricular canal defect. The cleft in the atrioventricular valve was closed completely in 25 patients and partially in 3 patients (those with a small left lateral leaflet). In complete atrioventricular canal, the ventricular septum defect was closed with a patch of polytetrafluoroethylene (Gore-Tex, W. L. Gore & Associates, Inc, Flagstaff, Ariz) or xenopericardium. Follow-up was complete and ranged from 3 to 21 months (median 11 months).

RESULTS: There were no early or late deaths and no surgical complications. The septum primum defect was closed completely in all patients as assessed by echocardiography. All the patients were in sinus rhythmus, and none had even a temporary complete atrioventricular block. The surgical result and heart rhythm have remained stable over time.

CONCLUSIONS: Direct closure of the septum primum is an easy, quick, and safe procedure during repair of atrioventricular defects.

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