Materials and Methods
A total of 56 patients; 33 females (60%), 23 males (40%) were operated for CAVSD in our clinic between 2009 and 2019. The demographic and surgical data of the patients with a median age of 18.19±29,9 months (2-180), the male and female numbers with ratios of 33 males (60%) and 23 females (40%), and the mean weight of 9.87±7.96 kg (3.3-41) are summarized in Table 1.
In preoperative echocardiography, 46 patients were determined to be Rastelli type A (82,2%), 7 patients were type B (12,5%), 3 patients were type C ( 5,3%). The mean VSD diameter was found to be 10.23 ± 4.47 mm (3-23). Preoperative LAVV regurgitation was determined to be moderate and severe in 28 and 9 patients, respectively while right AV valve regurgitation was also found in 24 and 9 patients, respectively. There was a mitral cleft in all patients. There was no preoperative left ventricular outflow truck obstruction (LVOTO) in any of our patients.
Additional anomalies are presented in Table 2.
Before total correction, 2 patients underwent BT shunt surgery, and 6 patients underwent pulmonary banding in the other centers.
As surgical techniques, cannulation of the ascending aorta after standard median sternotomy, bicaval venous cannulation, and moderate hypothermia were applied, and antegrade blood cardioplegia was used. The MSP technique was applied to 37 (66%) patients, and the TPT was applied to 19 (34%) patients. Mitral cleft repair was performed in all patients. Additional valve repair was performed on the left atrioventricular valve (LAVV) in 16 patients and the right atrioventricular valve (RAVV) in 16 patients. The conventional single-patch technique was not used in any of our patients.
Both patient groups were compared in terms of age groups, male-to-female ratio, VSD diameter, CPB and aortic ACC time, intubation time, length of ICU and hospital stay, drainage level, blood product usage amounts, mortality and morbidities such as postoperative left and right valve regurgitation, heart failure, infection, chylothorax, and cerebrovascular events.
The long-term results of the study were evaluated over 45 patients who could be followed up for 73,2 + 4,06 (22-128) months meanly.