Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-26T14:49:48.775Z Has data issue: false hasContentIssue false
  • English
  • Français

Atrioventricular valve repair along with Fontan completion

Published online by Cambridge University Press:  17 November 2014

Juan M. Gil-Jaurena ,
María T. González-López ,
Ramón Pérez-Caballero  and
Ana Pita
Juan M. Gil-Jaurena*
Affiliation:
Pediatric Cardiac Surgery, Hospital General Universitario Gregorio Marañón, Madrid, Spain
María T. González-López
Affiliation:
Pediatric Cardiac Surgery, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Ramón Pérez-Caballero
Affiliation:
Pediatric Cardiac Surgery, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Ana Pita
Affiliation:
Pediatric Cardiac Surgery, Hospital General Universitario Gregorio Marañón, Madrid, Spain
*
Correspondence to: J. M. Gil-Jaurena, Pediatric Cardiac Surgery, Hospital GU Gregorio Marañón, C/OʼDonnell 50, 28009, Madrid, Spain. Tel/Fax: +00 34 91 586 8000; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Atrioventricular valve regurgitation is widely known as a risk factor for Fontan completion in patients with univentricular physiology. To date, indications and timing for atrioventricular valve repair remain unclear and different surgical techniques have been advocated. Since 2013, 50 consecutive patients underwent extracardiac Fontan completion in our institution. Atrioventricular valve repair, by avoiding the use of a prosthetic ring, was performed as a concomitant procedure in three of them, with excellent short-term results. Beating-heart repair was performed in one of the patients with hypoplastic left heart syndrome as the underlying disease. Valve repair when moderate or severe regurgitation is present may be performed at a low risk. Both the staged approach of atrioventricular valve repair followed by the Fontan as a separate operation and the combined approach of simultaneous atrioventricular valve repair and Fontan have a role in the management of these complex patients. We highlight the importance of the use of “easy and simple” surgical techniques for repairing the atrioventricular valve in order to provide a better life prognosis in Fontan patients.

Keywords

Atrioventricular valve plastyFontansingle ventricle
Type
Brief Reports
Information
Cardiology in the Young , Volume 25 , Issue 7 , October 2015 , pp. 1421 - 1424
Check for updates
Copyright
© Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Elmi, M, Hickey, EJ, Williams, WG, et al. Long-term tricuspid valve function after Norwood operation. J Thorac Cardiovasc Surg 2011; 142: 1341–1347.Google Scholar
2. Stamm, C, Anderson, RH, Ho, SY. The morphologically tricuspid valve in hypoplastic left heart syndrome. Eur J Cardiothorac Surg 1997; 12: 587–592.Google Scholar
3. Ohye, RG, Gomez, CA, Goldberg, CS, et al. Repair of the tricuspid valve in hypoplastic left heart syndrome. Cardiol Young 2006; 16: 21–26.Google Scholar
4. Tsang, VT, Rajab, SG. Tricuspid valve repair in single ventricle: timing and techniques. Semin Thorac Cardiovasc Surg Pediatr Card Surg Ann 2012; 15: 61–68.Google Scholar
5. Mahle, WT, Cohen, MS, Spray, TL, et al. Atrioventricular valve regurgitation in patients with single ventricle: impact of the bidirectional cavopulmonary anastomoses. Ann Thorac Surg 2001; 72: 831–835.Google Scholar
6. Kanter, KR, Forbess, JM, Fyfe, DA, et al. De Vega tricuspid annuloplasty for systemic tricuspid regurgitation in children with univentricular physiology. J Heart Valve Dis 2004; 13: 86–90.Google Scholar
7. Ando, M, Takahashi, Y. Edge-to-edge repair of common atrioventricular or tricuspid valve in patients with functionally single ventricle. Ann Thorac Surg 2007; 84: 1571–1576.CrossRefGoogle ScholarPubMed
8. Mahle, WT, Gaynor, JW, Spray, TL. Atrioventricular valve replacement in patients with a single ventricle. Ann Thorac Surg 2001; 72: 182–186.Google Scholar