Atrioventricular Septal Defect ( AV Canal)

What is atrioventricular septal defect (AVSD)?

An AVSD is a congenial heart defect in which part of the wall or septum between the two upper chambers (atria) and the two lower chambers (ventricles) of the heart has holes or defects (ASD and VSD, respectively). In addition, the heart valves separating the atria from the ventricles are defective. Instead of having two valves, the mitral and the tricuspid valves, there is one common atrioventricular valve.

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What if my baby has an AVSD?

Babies with AVSD usually do well as newborns and can appear normal. There is a higher incidence of this congenital heart defect in children with Trisomy 21 or Down Syndrome. Initially the baby with an AVSD will need no treatment for the first one or two weeks of life. However, the baby usually will require “anticongestive” medications such as Lasix (a diuretic) and Digoxin (an inotrope) to prevent congestion of the lungs from too much blood flow.

Too much blood flow to the lungs is the main problem caused by an AVSD. Symptoms that may be observed are sweating, shortness of breath or fast breathing, tiring with feeds and failure to gain weight. The worst problem that can result from too much blood flow to the lungs is pulmonary hypertension (high blood pressure of the lungs).

Will medications be the only therapy required?

Medications (Lasix and Digoxin) are very helpful for patients with AVSD; however, it does not correct the underlying problem. To prevent pulmonary hypertension (a potentially irreversible and lethal condition) from developing, heart surgery should be performed around the age of three months.

How is surgery for ASVD performed?

The repair of AVSD involves open heart surgery. An incision is made through the sternum (breastbone) and the infant is placed on the heart-lung machine (cardiopulmonary bypass). First the defect between the ventricles (VSD) is repaired with a patch. This patch also divides the common atrioventricular (A-V valve) in two, thus creating a new mitral and tricuspid valve. To fully create a new mitral valve, further stitches have to be placed in the valve itself. The final aspect of the repair involves closing the defect between the two upper chambers (atria) or the ASD.

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What are the possible complications of repairing an AVSD?

Some complications are common to all open heart surgeries, including bleeding, having to give transfusion, stroke or death. Other possible complications related to repairing an AVSD are heart block (2-3%), which may require placement of a pacemaker, and eventual leakage from the newly created mitral valve (10-15%), which may require future repair or, less likely, replacement.

What kind of life can be expected after repair of AVSD?

After their AVSD is repaired, children grow normally, go to school, play with their friends and siblings and live productive lives. They will, however, need continued follow-up with a cardiologist.

Contact Information:

John Mark Morales MD, FACS, FAAP
Chief of Cardiothoracic, Director of Perfusion Services
Certified by the American Board of Surgery, American Board of Thoracic Surgery

Mark Bielefeld, MD
Driscoll Children's Hospital Chief of Staff
Certified by the American Board of Surgery, American Board of Thoracic Surgery

Thoracic surgeons are available for questions and consultations: (361) 854-0201. For appointments, assistance, and physician references in Corpus Christi call: (361) 854-0201 or 800-DCH-LOVE
Fax : 361-855-7572
E-MAIL : jmarkmorales@aol.com

For further information on any surgical procedures you can contact Carol Kaplan, RN, Surgical Nurse Liaison at (361) 694-5150. Consultation and surgery for inpatients is provided in concert with neonatology and pediatric cardiology departments. Complete evaluation and management for infants, children, adolescents and adults with congenital or acquired cardiac, vascular or thoracic anomalies.

Cardiothoracic Associates
3533 S. Alameda, Suite 202
Corpus Christi, Texas 78411
Phone: (361) 694-5150
Fax: (361) 855-7572
Hours: 9am to 6pm
Fri 9am to 5pm