Reoperation for left atrioventricular valve failure in repaired atrioventricular septal defect: Can more valves be preserved in the current era?

Abstract

In the current era, more LAVVs can be preserved at the time of redo-operation with excellent early and long-term survival and acceptable reoperation rates. LAVV morphology and presence of trisomy 21 did not affect outcome.

Redo mitral valve surgery following prior mitral valve repair

“…Another similar analysis of 188 patients undergoing mitral valve reoperation for recurrent mitral regurgitation after repair for degenerative disease demonstrated a 93% freedom from repeat mitral valve surgery at 10 years following re‐repair, with a 62% 10‐year survival . Mitral valve re‐repairs have also been successfully performed with good long‐term outcomes in patients with congenital mitral valve regurgitation due to left atrio‐ventricular valve dysfunction associated with septal defects …”

Redo mitral valve replacement in an adult with severe pulmonary hypertension resulting from structural valve deterioration and left ventricular outflow tract obstruction and a history of atrioventricular septal defect repair: a case report

“…Thus, the present patient presented with strong risk factors for LVOTO. Surgical techniques for left-sided atrioventricular valve repair in hearts with AVSD have been improved and standardized, building on experience from mitral valve repair techniques [ 8 ]. In the present case, repair for mitral valve regurgitation should have been considered initially.…”

“…Although elongation and narrowing of the left ventricular outflow tract (LVOT) in patients with atrioventricular septal defect (AVSD) is a well-known phenomenon [ 4 , 5 ], appropriate therapeutic strategies for coexisting left-sided atrioventricular valve disease in adults with AVSD have not been sufficiently discussed. To prevent left ventricular outflow tract obstruction (LVOTO) in cases of mitral valve replacement, appropriate size and orientation of the prosthesis are vital [ 6 , 7 ] and in the current era, preservation of more left-sided atrioventricular valves can be ensured, with excellent early and long-term survival and acceptable reoperation rates [ 8 ].…”

Posterior leaflet augmentation using a left atrial wall patch for severe left atrioventricular valve regurgitation after repair of an atrioventricular defect

“…Reoperation for mitral valve regurgitation may occur following the repair of a left atrioventricular (AV) septal defect . These valves may be re‐repaired using pericardial patches for leaflet augmentation, ring annuloplasty using both autologous pericardial and prosthetic annuloplasty rings, and neochordae .…”

“…Reoperation for mitral valve regurgitation may occur following the repair of a left atrioventricular (AV) septal defect. 1 These valves may be re-repaired using pericardial patches for leaflet augmentation, ring annuloplasty using both autologous pericardial and prosthetic annuloplasty rings, and neochordae. [2][3][4] We present images of the use of a patch of left atrial wall for posterior leaflet augmentation and the insertion of a prosthetic annuloplasty ring to repair a regurgitant mitral valve following a previous repair of an AV septal defect.…”