Common Arterial Trunk And Complete Atrioventricular Septal Defect Repair
Alan O'Donnell, PA-C, Dennis Wells, MD, David Morales, MD.
Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Common Arterial Trunk and Complete Atrioventricular Septal Defect Repair Summary:The combination of common arterial trunk and complete atrioventricular canal is exceedingly rare. There have only been 4 previous case reports of biventricular repairs performed of which 3 survived to hospital discharge. We present complete biventricular repair of an 8 month old infant with combination of type 1 common arterial trunk with tri-leaflet truncal valve and complete atrioventricular canal Rastelli Type C, a single dominant coronary artery from the anterior sinus, bilateral SVCs without a bridging vein and left SVC draining into the roof of the left atrium, and a right aortic arch with mirror image branching. Prior cardiac surgery consisted of bilateral pulmonary artery band placement at 4 days old.Additional patient factors included tracheomalacia, severe obstructive sleep apnea, gastrostomy tube and a chromosome 2 duplication of unknown significance. To our knowledge this is the first video demonstration of such a repair. Our patient continues to do well at last follow up 6 months following discharge.Operation performed:1)Repair of Common Arterial Trunk - Baffle from inlet VSD to truncal valve and placement of 12mm Hancock RV to PA Conduit2)Repair of Complete Atrioventricular Canal defect - Rastelli Type C with 2 Patch technique 3)Creation of Left SVC to Secundum ASD Tunnel 4)Patch closure of Coronary Sinus atrial septal defect 5)Removal of Bilateral PABs and patch augmentation of Left Pulmonary Artery
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