Overview
Complete atrioventricular canal (CAVC) is a congenital heart defect characterized by a common AV valve and often associated with complex intracardricular anomalies, leading to significant left-to-right shunting and potential heart failure 1.Diagnosis
Key Diagnostic Criteria: Echocardiography is essential for diagnosis, identifying the common AV valve, ventricular septal defect, and atrioventricular valve abnormalities 1.
Recommended Tests: Biplane cineangiograms for detailed ventricular volume assessment 1.
Grading: Ventricular end-diastolic volumes (EDV) typically exceed normal ranges preoperatively, with right ventricular (RV) and left ventricular (LV) EDVs often >149% and >184% of normal limits, respectively 1.Management
First-Line Treatment: Pulmonary artery banding (PAB) as a palliative procedure to reduce pulmonary blood flow and improve symptoms 1.
Corrective Surgery: Intracardiac repair to address the common AV valve and ventricular septal defect, aiming to normalize ventricular volumes 1.
Post-PAB Monitoring: Serial echocardiograms to monitor changes in ventricular volumes; risk of ventricular undersizing noted post-PAB 1.Special Populations
Pediatrics: Early surgical intervention is critical to prevent long-term complications; PAB and subsequent corrective surgery are standard approaches 1.Key Recommendations
Perform intracardiac repair to address CAVC defects aiming to normalize ventricular volumes post-operatively (Evidence: Moderate 1).
Utilize pulmonary artery banding as a palliative measure to manage excessive pulmonary blood flow before corrective surgery (Evidence: Moderate 1).
Monitor ventricular end-diastolic volumes closely pre- and post-PAB to identify and manage potential ventricular undersizing (Evidence: Weak 1).References
1 Fisher EA, Doshi M, DuBrow IW, Silverman N, Levitsky S. Effect of palliative and corrective surgery on ventricular volumes in complete atrioventricular canal. Pediatric cardiology 1984. link