title: Valvular repair for atrioventricular regurgitation in complex anomalies in modified Fontan procedure with reference to a single ventricle associated with a common atrioventricular valve.
abstract: Between January 1985 and October 1998, 169 of 372 patients who underwent a modified Fontan procedure had atrioventricular valve regurgitation (AVVR) that ranged in degrees from 1 to 4. Concomitant repair for AVVR was performed in the majority of cases. All but 12 patients had the AV valve repaired, mainly by circular annuloplasty; none had valve replacement. Although mortality was significantly higher in the AVVR cases (21 of 169 [12%]) than in the cases without AVVR (eight of 203 [3.9%]; P <.007, chi-square), actuarial survival in the AVVR cases was 83% at 5 years, 81% at 10 years, and 73% at 12 years. The degree of AVVR before surgery was 1.62 +/- 0.73 on average; 82 cases had more than grade 2 regurgitation. There was a significant decrease to 0.54 +/- 0.61 (P <.0001) after surgery in long-term survivors. Cases with AVVR can be treated with reasonable risk provided proper repair of the valve is performed. Circular annuloplasty is a simple and uniformly effective method with which to control regurgitation, even for the common AV valve. Copyright 1999 by W.B. Saunders Company
authors.affiliation: Department of Pediatric Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Imai
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Seo
authors.forename: Masatsuga
authors.initials: M
authors.lastname: Terada
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Aoki
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Shin'oka
authors.forename: Jun
authors.initials: J
authors.lastname: Ohta
authors.forename: Yuhsuke
authors.initials: Y
authors.lastname: Iwata