A New Method for Atrioventricular Valve Repair in Atrioventricular Septal Defect

The left atrioventricular valve in atrioventricular septal defect is conventionally repaired by suturing the "cleft." This can be complicated with stretching or dehiscence of the sutured zone by naturally diverging cordal traction and stenosis by restricting leaflet mobility. This complication prompted us to develop a different approach, especially for adults and adolescents, who might have undergone surgical repair previously. The technique consists of not closing or reopening the cleft, constructing neocordae connecting the cordless edge of each bridging leaflet to the opposite papillary muscle-that is, the papillary muscle to which it has no natural connection ("crossing neocordae")-and inserting an annuloplasty ring.