Biventricular repair using subvalvular techniques for unbalanced atrioventricular septal defect

Area of Science:

• Pediatric Cardiology
• Congenital Heart Disease Surgery
• Cardiac Valve Repair

Background:

• Unbalanced atrioventricular septal defects (AVSD) present complex surgical challenges, particularly with severe atrioventricular valve regurgitation.
• Effective biventricular repair strategies are crucial for improving outcomes in pediatric patients with complex congenital heart disease.

Purpose of the Study:

• To describe a successful biventricular repair in a young child with a right-dominant unbalanced atrioventricular septal defect and severe atrioventricular valve regurgitation.
• To evaluate the short-term postoperative outcomes and adaptation to biventricular circulation.

Main Methods:

• The patient underwent a complex surgical repair involving basal chordae resection, artificial chordae reconstruction, and left-sided atrioventricular valvuloplasty.
• Postoperative assessment included clinical evaluation for heart failure symptoms and monitoring of weight gain and circulatory adaptation.

Main Results:

• The 19-month-old patient demonstrated successful biventricular repair with minimal heart failure symptoms at 14-month follow-up.
• Significant weight gain and successful adaptation to biventricular circulation were observed postoperatively.

Conclusions:

• Biventricular repair using basal chordae resection, artificial chordae reconstruction, and atrioventricular valvuloplasty is a viable option for managing complex unbalanced atrioventricular septal defects with severe valve regurgitation in pediatric patients.
• This surgical approach can lead to favorable short-term outcomes, including improved clinical status and adaptation to biventricular physiology.