Progressive atrioventricular valvular regurgitation in single ventricle

Area of Science:

• Cardiology
• Pediatric Cardiology
• Congenital Heart Disease

Background:

• Hemodynamic status in single ventricle patients is dynamic.
• Atrioventricular (AV) valve malfunction is a potential complication.
• Single ventricle physiology presents unique challenges in cardiovascular management.

Purpose of the Study:

• To describe the rapid development of mechanical AV valve malfunction in single ventricle patients.
• To identify the characteristics and outcomes of AV regurgitation in this population.
• To evaluate the efficacy of surgical management for AV regurgitation.

Main Methods:

• Review of 80 patients with single ventricle.
• Identification of 8 patients with moderate to severe AV regurgitation.
• Cardiac catheterization to assess AV regurgitation and ventricular function.
• Surgical intervention in 4 patients (AV valve replacement or repair).

Main Results:

• Eight patients developed moderate to severe AV regurgitation, median age 15 years.
• All symptomatic patients presented with severe congestive heart failure.
• AV regurgitation was not present on earlier catheterization.
• Surgical findings included abnormal valve morphology and myxomatous degeneration.
• Three of four surgically treated patients survived with improved condition.

Conclusions:

• AV regurgitation is a significant complication in single ventricle patients with a single AV valve.
• Early recognition of AV regurgitation is critical.
• Surgical management should be considered before myocardial dysfunction develops.