Surgery for Partial Atrioventricular Septal Defect in a Septuagenarian Patient

Abstract

Surgery for an atrioventricular septal defect (AVSD) is rare in septuagenarians. This is the case of a 75-year-old man with partial AVSD. He developed dyspnea on exertion. Detail examinations revealed partial AVSD, severe left atrioventricular valve (LAVV) regurgitation, severe right atrioventricular valve (RAVV) regurgitation, persistent atrial fibrillation, and coronary artery stenosis, which required surgical intervention. Subsequently, we performed ostium primum-type atrial septal defect closure using an autologous pericardium patch, LAVV replacement with a bioprosthetic valve, RAVV repair without annuloplasty, a modified Maze IV procedure, left atrial appendage closure, and coronary artery bypass grafting. Although LAVV repair for LAVV regurgitation was initially performed, it was converted to LAVV replacement because the repair could not control the regurgitation due to advanced degenerative changes with the thickening of the leaflets. The patient was discharged on the 15th postoperative day uneventfully. One and a half years after surgery, he had neither cardiovascular events nor arrhythmias.