TITLE:
Outcomes of Total Repair of Atrioventricular Canal Defects: A Two-Decade Single-Centre Experience
AUTHORS:
Miriam Nalule, Stefano Marianeschi, Luigi Arcieri, Ylenia Claudia Maria Brindicci, Francesco Arlati, Michael Oketcho, Muhoozi Rwakaryebe, Kenneth Ahabwe, Herbert Ariaka, Tom Mwambu, John Mukisa
KEYWORDS:
Atrioventricular Canal Defects, Complete Atrio Ventricular Canal Defect, Complete Repair, Outcomes
JOURNAL NAME:
Open Access Library Journal,
Vol.13 No.6,
June
30,
2026
ABSTRACT: Background: Atrioventricular canal defect (AVCD) is considered to be one of the complex congenital heart diseases. It is categorized as a spectrum, from the simple partial AVCD to the most complex, the complete AVCD. Surgical repair of AVCD is the optimal management option for this condition. We carried out this study to analyse our centre’s experience regarding the outcomes of the management of this condition. Patients and Methods: Medical records of patients who underwent AV canal repair from January 2003 to December 2023 were reviewed retrospectively and the clinical data, including age at operation, weight, type of surgery, associated co-anomalies, palliation, etc., were collected and assessed. The outcomes of surgery, including mortality, length of hospital stay, pacemaker insertion for Atrioventricular block and redo surgery, were analysed. Results: The study looked at 110 patients diagnosed with AV canal defect and underwent total corrective repair during the period from January 2003 until December 2023. Fifty-nine of the patients (53.6%) were females. Out of the 110 patients, 45 patients (40.9%) were diagnosed with Down syndrome. 59% of these had CAVCD. Among those with associated malformations 14 had PDAs and 5 had Tetralogy of fallot. 8 (12.9%) of these patients had to undergo palliative procedures before definitive surgery. Median (IQR) age at the time of surgery was 6 (4 - 9) months with a mean (SD) weight of 12.1 (16.6) kg. The choice of operative procedure was the double-patch surgical technique for CAVCD and patch repair of ASD and cleft repair for the partial AVCD. In the postoperative period, we had 4 (3.6%) deaths in hospital, with 3 dying on the table. Five patients had permanent pacemakers inserted due to AV block. The average length of hospital stay was 15 days, with patients post CAVCD repair spending longer in the 3 categories, with a mean length of stay of 16 days. There were 5 (4.5%) reoperations before discharge, 3 for severe LAVVR, 1 for residual VSD and 1 for both residual VSD and severe RAVVR. 5 patients were readmitted for reoperation, with 3 for severe LAVVR and 1 for PDA closure and another for subaortic membrane resection. Conclusion: From our study, Atrioventricular septal defects, especially the CAVCD, were safely corrected between 3 and 6 months with less morbidity. The other types were safely operated on later after 1st year of life, especially the partial type. The commonest cause of redo surgery is the regurgitation of the LAVV component, especially in patients with CAVCD. AV block occurs more in patients with CAVCD and subsequent permanent pacemaker insertion. Overall, partial AVCD and intermediate AVCD have less morbidity compared to CAVCD with less mortality, shorter hospital stays and complications of AV blocks.