Management and outcome of atrioventricular (AV) canal defects
- Craig E Fleishman, MD
Craig E Fleishman, MD
- Associate Professor of Pediatrics
- University of Central Florida College of Medicine
- Aykut Tugertimur, MD, FACC
Aykut Tugertimur, MD, FACC
- Attending Pediatric Cardiologist
- Assistant Professor of Pediatrics
- Hofstra Northwell School of Medicine
- Section Editors
- John K Triedman, MD
John K Triedman, MD
- Section Editor — Pediatric Cardiology
- Professor of Pediatrics
- Harvard Medical School
- Heidi M Connolly, MD, FASE
Heidi M Connolly, MD, FASE
- Section Editor — Congenital Heart Disease
- Professor of Medicine
- Mayo Medical School
Atrioventricular (AV) canal defects are a group of congenital cardiac defects involving, to varying extent, the AV septum and AV valves (ie, mitral and tricuspid valves). They are also referred to as AV septal defects, endocardial cushion defects, or persistent AV ostium.
The management and outcome of patients with AV canal defects will be reviewed here. The anatomy, pathophysiology, clinical features, and diagnosis of AV canal defects are discussed separately. (See "Clinical manifestations, pathophysiology, and diagnosis of atrioventricular (AV) canal defects".)
VARIOUS FORMS OF AV CANAL DEFECTS
●Complete AV canal defect is a result of complete failure of fusion between endocardial cushions. It is characterized by a primum atrial septal defect (ASD) that is contiguous with a ventricular septal defect (VSD) and a common AV valve.
●Partial AV canal defect is due to incomplete fusion of the endocardial cushions and consists of a primum ASD and a common valvular annulus with two separate valve orifices. Due to abnormal fusion of the left tubercle of the superior and inferior cushions, the anterior leaflet of the mitral valve is cleft, which is often associated with mitral valve regurgitation.
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- VARIOUS FORMS OF AV CANAL DEFECTS
- OVERVIEW OF MANAGEMENT
- COMPLETE AV CANAL DEFECT
- Initial medical management
- Surgical interventions
- - Primary complete repair
- Surgical timing
- Surgical procedures
- Cleft AV valve
- - Single ventricle palliation
- PARTIAL AND TRANSITIONAL AV CANAL DEFECT
- Postoperative complications
- - Pulmonary hypertension
- - Arrhythmias
- - AV valve complications
- AV valve regurgitation
- AV valve stenosis
- Transesophageal echocardiography
- Long-term outcome
- FOLLOW-UP CARE
- Physical examination
- Endocarditis prophylaxis
- Neurodevelopmental outcome
- SUMMARY AND RECOMMENDATIONS