Valve mobilization and augmentation in systemic atrioventricular valve plasty

Abstract

Repair of the systemic atrioventricular valve before a bidirectional cavopulmonary shunt is challenging. We describe a novel approach to atrioventricular valve repair in an infant who had severe regurgitation associated with right isomerism and a single ventricle. The atrioventricular valve showed downward displacement with tethering. Atrioventricular valve plasty using our valve mobilization technique and pulmonary artery banding were performed at age 3 months. Posterior leaflet augmentation was performed 1 month later for the remaining moderate regurgitation. The severity of regurgitation was reduced to less than mild. After the Glenn and Fontan operations, reintervention was unnecessary.