Partial Atrioventricular Canal: Pitfalls in Technique

Partial atrioventricular (AV) canal represents approximately 25% of all AV septal defects. While often grouped with secundum ASD from the perspective of cardiopulmonary physiology, clinical presentation, and timing of surgical correction, their optimal management truly requires an understanding of their anatomic similarities to other forms of common AVC defects. By most measures, outcomes for surgical management of partial AV canal has improved over the last four decades, though some aspects of these defects continue to pose important challenges. Current experience has witnessed the reduction in early mortality and only rare complete heart block. Left AV valve dysfunction remains the most common indication for reoperation (10%) with LVOT stenosis the next most common reason (10% to 15% incidence, 5% to 10% reoperation rate). It is important to understand in this population that postoperative left AV valve problems and LVOT stenosis may be intimately linked, both from an etiologic standpoint, and with respect to their management.