Atrioventricular Canal Surgery
What is an atrioventricular canal (AV canal, endocardial cushion defect)?
This
heart problem is present at birth and includes an atrial septal
defect (ASD) low in the atrium, a ventricular septal defect
(VSD) high in the ventricle and a common atrioventricular
valve. These problems occur when the center area of the heart
does not form correctly. The severity of this heart defect
varies, depending on how much of the septum of the heart is
present.
Preparing for the procedure
Prior to cardiac surgery, this heart defect will be diagnosed with an EKG, a chest- x-ray and an echocardiogram. Some children require cardiac catheterization to measure the level of the pressure in the lungs. This measurement helps determine if high pressure increases the risks of surgery. It also helps the medical staff prepare for the child's care after surgery. In addition, blood tests are needed to be sure there is no infection, no problem with clotting and normal electrolytes. A blood test to determine the blood type and compatibility will be performed so blood will be available for the surgery.
During the procedure
The
child will be placed under general anesthesia, and special
monitoring IVs will be put in. The chest is entered through
the sternum (breastbone). The heart/lung machine is connected.
With the heart stopped and empty, the right atrium is openedand
the defect is carefully analyzed. The repair is done with
one or two patches, depending upon the particular circumstances,
and the common valve is separated to function as two valves.
The heart is then allowed to fill and start beating. A drainage
tube and temporary pacemaker wires are placed, and the chest
is closed. Usually, a transesophageal
echocardiogram is performed to inspect and verify the
adequacy of the repair. The child usually remains on the breathing
machine for a few hours (sometimes overnight). When the heart
appears stable and strong enough, the child will be allowed
to awaken and will be taken off the breathing machine.
After the procedure
After surgery, the child will need a number of days to recover from anesthesia, the use of the heart-lung bypass equipment and the surgery. Initially, the child will be on a ventilator (breathing machine) and may need support from IV medicines and a temporary pacemaker. Once the breathing tube (endotracheal tube) is out, the main goals are to return to normal activity and encourage the child to eat normally and gain weight.
Click here for recovery guidelines after discharge for congenital heart defect repair at the Inova Heart Center.
- Atrial Septal Defect (ASD) Repair
- Ventricular Septal Defect
- Tetralogy of Fallot Repair
- Arterial Switch for TGA
- Atrioventricular Canal Surgery
- Bidirectional Glenn
- Fontan
- Heart Valve Repair and Replacement
- Ross Procedure for AVR
- Patent Ductus Arteniosus
- Coarctation of the Aorta Repair
- Systemic to Pulmonary Shunt
- Pediatric Recovery
