Original article: cardiovascularAtrioventricular valve replacement in patients with a single ventricle
Section snippets
Patient population
We retrospectively reviewed the surgical database at our institution to identify all patients with single ventricle lesions who underwent AVV replacement between January 1, 1984, and August 1, 2000. Data from operative notes, cardiac catheterization, and echocardiography were reviewed to identify the mechanism of AVV insufficiency and whether previous valvuloplasty had been performed. The primary outcome variable was hospital mortality. Additional outcome measures included late death,
Preoperative characteristics
Between January 1, 1984, and August 1, 2000, more than 1,700 patients with single ventricle underwent operations at our institution. AVV replacement was undertaken in 17 of these patients. The median age at operation was 3.0 years (range 7 days to 17.3 years). The median weight at operation was 22.7 kg (range 2.6 to 50.6 kg). The incompetent AVV was of tricuspid morphology in 7 (41%), mitral in 2 (12%), common AV canal in 6 (35%), double-inlet left ventricle in 1 (6%), and straddling tricuspid
Comment
Despite improving results with cavopulmonary operation in patients with single ventricle, the development of significant AVV insufficiency continues to present a challenge in the management of this population. When possible, valve repair with preservation of the native architecture is the procedure of choice. Several investigators have reported excellent early results associated with valvuloplasty for a variety of single ventricle lesions 1, 2. Reparative techniques have included reduction
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