title: Biventricular repair for common atrioventricular canal defect with parachute left atrioventricular valve.
abstract: OBJECTIVE
  Parachute left atrioventricular (AV) valve can complicate repair of common atrioventricular canal (CAVC), and single-ventricle palliation is sometimes preferred. The goal of this study is to review our single institutional experience in biventricular repair in this patient group.
  
  
  METHODS
  The demographic, procedural and outcome data were obtained for all children who underwent biventricular repair for complete CAVC with parachute [single left ventricular (LV) papillary muscle] or forme fruste parachute left AV valve (closely spaced LV papillary muscles) from 2001 to 2012. Primary outcomes were survival, freedom from left AV valve stenosis (defined as an inflow gradient ≥7 mmHg and post-capillary pulmonary hypertension) and freedom from left AV valve replacement.
  
  
  RESULTS
  A total of 24 patients were included (21 parachutes, 3 forme frustes). There was 1 early death (4.2%). At discharge, no patient had more-than-mild regurgitation and 1 had stenosis. During a median follow-up of 3.7 years (IQR 4 months to 5 years), there were 2 late deaths (8.3%), 6 patients (25%) presented significant left AV valve stenosis and 2 patients (8.3%) required valve replacement. Freedom from stenosis was 95 ± 4.9% at 1 year, 83.1 ± 8.9% at 3 years, 64.7 ± 13.5% at 5 years and 51.7 ± 15.8% at 10 years. Complete cleft closure was not associated with a significantly different freedom from left AV valve reoperation (log-rank test, P = 0.89) or significant stenosis (P = 0.47).
  
  
  CONCLUSIONS
  Biventricular repair in parachute left AV valve and CAVC is feasible with acceptable mortality and freedom from stenosis. The burden of reoperation remains significant in this patient group.
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA Division of Cardiovascular Surgery, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland patrick.myers@hcuge.ch.
authors.forename: Patrick O
authors.initials: PO
authors.lastname: Myers
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Pedro J
authors.initials: PJ
authors.lastname: del Nido
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Victor
authors.initials: V
authors.lastname: Bautista-Hernandez
authors.affiliation: Department of Cardiology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Gerald R
authors.initials: GR
authors.lastname: Marx
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Sitaram M
authors.initials: SM
authors.lastname: Emani
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Frank A
authors.initials: FA
authors.lastname: Pigula
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Michele
authors.initials: M
authors.lastname: Borisuk
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Baird
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006343:Heart Septal Defects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008297:Male; D008944:Mitral Valve Insufficiency / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Biventricular repair; Common atrioventricular canal defect; Mitral stenosis