Skip to main content Accessibility help
×
Home

Atrioventricular valve repair along with Fontan completion

  • Juan M. Gil-Jaurena (a1), María T. González-López (a1), Ramón Pérez-Caballero (a1) and Ana Pita (a1)

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.

Copyright

Corresponding author

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: giljaurena@gmail.com

References

Hide All
1. Elmi, M, Hickey, EJ, Williams, WG, et al. Long-term tricuspid valve function after Norwood operation. J Thorac Cardiovasc Surg 2011; 142: 13411347.
2. Stamm, C, Anderson, RH, Ho, SY. The morphologically tricuspid valve in hypoplastic left heart syndrome. Eur J Cardiothorac Surg 1997; 12: 587592.
3. Ohye, RG, Gomez, CA, Goldberg, CS, et al. Repair of the tricuspid valve in hypoplastic left heart syndrome. Cardiol Young 2006; 16: 2126.
4. Tsang, VT, Rajab, SG. Tricuspid valve repair in single ventricle: timing and techniques. Semin Thorac Cardiovasc Surg Pediatr Card Surg Ann 2012; 15: 6168.
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: 831835.
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: 8690.
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: 15711576.
8. Mahle, WT, Gaynor, JW, Spray, TL. Atrioventricular valve replacement in patients with a single ventricle. Ann Thorac Surg 2001; 72: 182186.

Keywords

Atrioventricular valve repair along with Fontan completion

  • Juan M. Gil-Jaurena (a1), María T. González-López (a1), Ramón Pérez-Caballero (a1) and Ana Pita (a1)

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed