Comparative Efficacy of Modified Single-Patch versus Double-Patch Techniques in Atrioventricular Septal Defect Repair

Aim: This study aims to compare the early- and mid-term outcomes of modified single-patch and double-patch techniques for complete atrioventricular septal defect (AVSD) repair. We hypothesized that the modified single-patch technique offers similar or superior efficacy while reducing surgical complexity.Materials and Methods: We conducted a retrospective analysis of 66 patients who underwent complete AVSD repair between January 2006 and December 2019. Patients were stratified into two groups based on the surgical technique: Modified Single-Patch (Group 1, n=45) and Double-Patch (Group 2, n=21). Demographic data, intraoperative parameters (aortic cross-clamp and cardiopulmonary bypass times), early morbidity-mortality, and mid-term echocardiographic results were assessed.Results: The double-patch group had significantly longer aortic cross-clamp (71 vs. 48 minutes, p < 0.001) and cardiopulmonary bypass durations (91 vs. 68 minutes, p < 0.001). While early mortality did not differ significantly between groups, pulmonary complications were significantly more frequent in the double-patch group (42.9% vs. 13.3%, p = 0.01). At mid-term follow-up (median 8 years), the double-patch group exhibited significantly higher rates of residual ventricular septal defects (23.8% vs. 2.2%, p = 0.011) and severe left atrioventricular valve insufficiency (19.0% vs. 6.7%, p = 0.025).Conclusion: Our findings indicate that the modified single-patch technique reduces surgical times, decreases residual defect rates, and better preserves left atrioventricular valve function in anatomically suitable cases. This technique stands out as a preferable surgical approach to mitigate long-term adverse outcomes.