Late correction of Rastelli type A complete atrioventricular canal

A 4-year-old male with Down syndrome was diagnosed with a complete atrioventricular
canal defect type A (Rastelli), ostium primum ASD, and inlet-type VSD. Despite his age,
he showed preserved cardiopulmonary function and a positive vasoreactivity test,
allowing surgical correction using a single autologous pericardial patch technique.
Postoperative follow-up revealed hemodynamic improvement and gradual reduction of
right ventricular pressure under medical therapy. This case highlights late surgical
feasibility in a patient with trisomy 21 and complete AV canal, possibly influenced by
favorable anatomic and genetic protective factors reported in the literature.
Keywords: atrioventricular (AV) canal, Down syndrome, cardiac catheterization,
pulmonary hypertension.