AV Canal Repair

AV canal is a complex heart condition and several different techniques of repair have been used. We present different techniques that we adapt to individual patient anatomy.

The first infant we presented had complete AV canal with a large VSD with minimal chordal attachments to the ventricular septum. We utilised a two patch technique with two autologous pericardial patches in this patient because we believe that had the lowest chance of distortion of the AV valve leaflets.

The second infant had complete AV canal with multiple dense chordal attachments of the AV valve leaflets to the ventricular septum and so we utilised the "Australian" technique for repair with one autologous pericardial patch.

The third patient had a partial AV canal but presented at an older age and so had dilation of the mitral annulus with moderate mitral regurgitation. Simple cleft closure in this patient was not adequate to repair the mitral regurgitation. An additional commisuroplasty had to be performed on the annulus near the junction of the inferior bridging leaflet and the mural leaflet.

All patients had a successful repair with uncomplicated post operative course. Different surgical approaches can be used with AV canal with differing intracardiac anatomy to obtain best surgical outcomes.