Open Access

CASE REPORT

Case Report: A Third Patch as a Saviour in an Unsuccessful Complete Atrioventricular Septal Defect Repair

Emrah Şişli^1,*, Pelin Köşger²

1 Section of Paediatric Cardiovascular Surgery, Department of Cardiovascular Surgery, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, 26040, Türkiye
2 Section of Paediatric Cardiology, Department of Paediatrics, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, 26040, Türkiye

* Corresponding Author: Emrah Şişli. Email:

(This article belongs to the Special Issue: Novel Methods and Techniques for the Management of Congenital Heart Disease)

Congenital Heart Disease 2025, 20(4), 531-537. https://doi.org/10.32604/chd.2025.067271

Received 29 April 2025; Accepted 25 June 2025; Issue published 18 September 2025

Abstract

Residual atrioventricular valve regurgitation after correction of complete atrioventricular septal defect (cAVSD) is still not ideal. As a modification of the double-patch method, our technique comprises a suture-bite-wide strip of a third patch that is incorporated to the upper margin of the left side of the ventricular septal defect (VSD) patch. This third patch counteracts not only the valvular tissue loss caused by the suture bites but also the rightward displacement of the VSD patch in a bulged fashion that occurs with increased left ventricular pressure after weaning from cardiopulmonary bypass. This unfavorable outcome was addressed with the current technique through augmentation of the left-sided bridging leaflets serving to prevent the separation of them from their corresponding mural leaflets. The concept was applied in two cases with Down syndrome aged 5 months and 6 months, respectively, as a rescue procedure in the same session just after a failed cAVSD repair. Since the immediate- and short-term outcomes of the atrioventricular valves in regard to regurgitation are satisfying, we believe that the technique proposed herein holds promise for the future in terms of tackling residual atrioventricular valve regurgitation.

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Keywords

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Supplementary Material

Supplementary Material File

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