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Reoperations can be challenging for patients who experience left and right atrioventricular valve failure after repair of a complete atrioventricular septal defect. Herein, we present a case of a 10-year-old boy who developed dysfunction in left and right atrioventricular valve following surgery for a complete atrioventricular septal defect. The patient underwent successful replacement of his left atrioventricular valve with a mechanical valve due to severe stenosis. Additionally, his right atrioventricular valve, in which the bridging leaflets adhered to the ventricular septal defect patch, causing the significant regurgitation, was repaired. The bridging leaflets were augmented using the autologous pericardium treated with ethanol after detaching the leaflets and chordae from the patch. Postoperative echocardiography showed that the prosthetic valve was functioning well, with no significant regurgitation in the right atrioventricular valve. This technique could benefit patients experiencing complex valve failures following atrioventricular septal defect surgery.

Acute rupture of the chordae tendineae of the mitral valve could lead to severe mitral regurgitation and circulatory collapse in infants. Mitral valve replacement may be often challenging because of the valve-annulus size mismatch in small infants when mitral valve repair cannot be accomplished. We present an infant with acute massive rupture of the chordae tendineae of the mitral valve who successfully underwent supra-annular mitral valve replacement using the short composite valve of an expanded polytetrafluoroethylene( ePTFE) graft and a mechanical valve. His mechanical valve has been functioning without complications such as thrombosis and pulmonary venous obstruction for 20 months after surgery. This technique could be helpful even infants with acute rupture of the chordae tendineae of the mitral valve whose left atrium may not be dilated.