Surgical management of the complete atrioventricular septal defect: literature review and case report

Abstract

Complete atrioventricular septal defect is a complex congenital cardiac defect caused by failure of septal separation, frequently associated with Down syndrome. It is considered a significant challenge in terms of diagnostic and therapeutic management. Our work aims to provide an update on the clinical and therapeutic aspects of the complete AVSD managed by our team at University Hospital Ibn Sina of Rabat, highlighting the importance of developing pediatric cardiac surgery in our Moroccan healthcare system. A retrospective descriptive study involved 20 patients who underwent surgery for complete AVSD between January 2020 and December 2023. Medical records were used to collect clinical, echocardiographic, surgical, and follow-up data. The median age at surgery was 7.5 months, and 90% of the patients had Down syndrome. Among the 20 included patients, 19 survived the intervention, yielding a survival rate of 95%. Postoperative complications included transient severe pulmonary hypertension in 4 patients (20%), moderate residual mitral insufficiency in 6 patients (30%), and rare complications such as septic shock and chylothorax. The single-patch repair technique was employed in 95% of cases. Complete CAV requires a multidisciplinary approach. This study highlights the importance of early diagnosis and timely surgical intervention in improving clinical outcomes and reducing morbidity and mortality.