Atrioventricular valve repair in patients with a single ventricle: emulating the fibrous skeleton of the heart

Atrioventricular valve (AVV) dysfunction is a common cause of reoperation and morbidity in patients with atrioventricular septal defects (AVSDs). In the setting of AVSD with single ventricle physiology, the risk of AVV failure is particularly high, and repair of the common AVV in these patients is notoriously challenging. Furthermore, patients with significant residual AVV regurgitation, after attempted repair, are at particularly high risk of mortality. One of the key factors which contributes to regurgitation in patients with a common AVV is the lack of a normal fibrous skeleton of the heart. We report a repair technique which utilizes a bridging annuloplasty in order to emulate the normal fibrous skeleton of the heart.