Between May 1987 and December 1996, repair of the "Ostium Atrioventricularis Communis" (OAVC), with total shaping by means of a double bovine pericardial patch and tricuspidation of the left atrioventricular valve (AVV) was performed on 34 consecutive patients with overall mortality of 5 patients (pat.) (14.7%). Group I: Less than 6 months (m) 12 pat. (1 death: 8.3%); Group II: 7m to 12m, 15 pat. (4 deaths: 26.6%) and Group III: between 1 and 5 years (y) 7 pat. (no deaths). Two deaths occurred later (residual mitral insufficiency + congestive heart failure and pneumonia + respiratory insufficiency). Two children received implants of definitive pacemakers (after 45 days and 4 years). Despite the fact that 2 registered insufficiency of the left AVV and one showed insufficiency of the right AVV, these cases were controlled clinically and no children were reoperated. The remaining children are classified between degree I and II of the New York Heart Association (NYHA). Although 29 patients weighted less than 10 kg, extracorporeal circulation was utilized together with hypothermia at 25°C without total circulatory interruption. The repair was inillated at the apposition zone of the single AVV with one or two stitches in figure-of-8s, preserving the tricuspid. Suturing the first bovine pericardial patch in drop-shape and fifting it between the chordae tendineae of the right side of the septum, followed by suturing of the second patch with simultaneous apposition with the single AVV and in this way, septing the 4 cavities. The advantages of this technique are: preservation of valve integrity, greater functional durability of the left AVV and reduced possibility of reoperation even in younger patients. The operation is performed preferably at the age of about 6 months.
Heart valves; Heart ventricle; Heart ventricle; Atrium; Atrium
