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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Pediatric Cardiology
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1510143

Mid-term outcomes of atrioventricular valve repair in functional single ventricle patients

Provisionally accepted
Yongqiang Jin Yongqiang Jin *qingyu wu qingyu wu xiaoya zhang xiaoya zhang lixin fan lixin fan enrui zhang enrui zhang hui xue hui xue Ming-Kui Zhang Ming-Kui Zhang
  • First Hospital of Tsinghua University, Chaoyang, China

The final, formatted version of the article will be published soon.

    Background: Surgical treatment of functional single ventricle combined with atrioventricular valve regurgitation remains a clinical challenge. The outcomes of atrioventricular valve repair in patients with single ventricle are limited. Methods: A retrospective study was conducted of all 28 patients with functional single ventricle treated with single-ventricle palliation who underwent atrioventricular valve operation at the First Hospital of Tsinghua University between April 2007 and October 2022. Results: In our cohort, the female/male ratio was 7:21, with an average age of 8.7±6.0 (0.75-26) years. Half of patients (50%) were right-ventricle type for single-ventricle morphology. 18 patients (64.3%) were with a common atrioventricular valve. Twenty-three patients (82.1%) were combined with heterotaxy syndrome. Pre-operatively, twenty-four patients (85.7%) were diagnosed with severe atrioventricular valve regurgitation. AVV was repaired at the Glenn (n=16, 57.1%), Glenn-Fontan (n=2, 7.1%) and Fontan (n=10, 35.7%) stage, respectively. Valve plastic techniques included valve annulus/commissure constriction (n=24), clefts repair (9 cases), edge-to-edge suturing (13 cases) and common atrioventricular valve separation (4 cases). The early mortality was 3.6% (1/28). All survival patients were observed with improved regurgitation situations. Twenty-two patients (78.5%) were observed with no more than mild regurgitation postoperatively. The mean follow-up time was 5.4±2.9 years (range, 3.08-11.83 years), with late mortality of 11.1% (3/27). All these three cases were observed with a severe regurgitation by echocardiogram in the last follow-up. Besides, reoperation rate of this cohort was 3.6% (1/28). Conclusions: AVV repair could significantly improve AVV function in SV patients combined with severe AVVR, with satisfactory mid-term results. Part of the cohort showed poor prognosis due to repeated AVVR. Regular follow-up by echocardiogram is critically important for these patients.

    Keywords: Single-ventricle, Atrioventricular valve repair, Fontan, Glenn, Operation timing

    Received: 12 Oct 2024; Accepted: 27 Nov 2024.

    Copyright: © 2024 Jin, wu, zhang, fan, zhang, xue and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yongqiang Jin, First Hospital of Tsinghua University, Chaoyang, China

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