Repair of atrioventricular dissociation defects through right subaxillay incision with non-stop cardiac impulse: report of 24 cases

Objective: To summarize the experience in repairing the atrioventricular dissociation defects by microtraumatic surgery with non-stop cardiac impulse.Methods: Twenty-four cases of congenital atrioventricular dissociation defects were repaired through the right subaxillay incision with extracorporeal circulation and the heart beating.The atria defects in 2 cases complicated with partial anomalous pulmonary venous connection(PAPVC) were enlarged and the right pulmonary vein which had been drained to the right atrium was isolated to the left atrium with a displaced septum;the valve junction incision was performed in 2 cases complicated with pulmonary valve stenosis,3 cases complicated with tricuspid valve incompetence received tricuspid valve plastic operation.Results: No deaths or complications such as residual shunt,gaseous emboli or low cardiac output were observed.The right atrium posterior wall and the right lower pulmonary veins in 2 of the cases were damaged separately;1 had transient hemoglobinuria and 1 arrhythmia.Conclusions: The procedure of right subaxillay incision with extracorporeal circulation and non-stop cardiac impulse causes little trauma,but it must be operated safely and accurately.