Mechanical valve replacement in complete atrioventricular septal defect—the decision making between common atrioventricular valvuloplasty and valve replacement in Fontan circulation
- VernacularTitle:完全型房室间隔缺损人工瓣膜置换一例—站在“单心室循环共瓣成形或换瓣”分岔路口的思考
- Author:
Chuhao DU
1
;
Shuo DONG
1
;
Yabing DUAN
1
;
Yangxue SUN
1
;
Jun YAN
1
Author Information
1. Department of Pediatric Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P.R.China
- Publication Type:Journal Article
- Keywords:
Common atrioventricular valve;
surgical repair of functional single ventricle;
replacement of artificial valve
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2021;28(04):492-494
- CountryChina
- Language:Chinese
-
Abstract:
A 12-year-old girl with double outlet of right ventricle, complete atrioventricular septal defect, pulmonary valve stenosis, single atrium, inferior vena cava-hemiazygos vein drainage and left isomerism, who had undergone surgical left superior vena cava-pulmonary artery connection was referred to our hospital. Echocardiography revealed thickening, crimping and malalignment of common atrioventricular valve, moderate-to-severe regurgitation mainly from the left side and the main pulmonary artery was poorly developed. We preserved the autologous valve and used the 31# mechanical mitral valve which was sutured to mitral annulus. After the main pulmonary artery was transected, proximal end was sutured and a 20# Gore-tex artificial vessel was anastomosed to the distal end of the main pulmonary artery. We excised hepatic vein from the right atrium which was then anastomosed to another artificial vessel. Postoperative oxygen saturation was 95%-100%. Echocardiography and CT showed that the function of mechanical valve and heart was good before discharge. Common atrioventricular valvuloplasty is the preferred choice of the management of impaired valve. However, when dysfunction of valve is too severe and valvuloplasty is more likely to fail, the risk of barely performing a valvuloplasty will increase dramatically. On this condition, the mechanical valve replacement should be performed.
