[Valvulo-annuloplasty for atrioventricular valvular regurgitation in univentricular heart and double outlet right ventricle].

Valvulo-annuloplasty for atrioventricular (AV) valvular regurgitation was performed in 10 patients with univentricular heart and double outlet right ventricle. Kay annuloplasty alone was employed in three patients with a quadricuspid or tricuspid common AV valve. Two of them died after the operation and the remaining one is waiting for reoperation because of recurrence of severe AV valve regurgitation. The suturing-up of free margins of the anterior and posterior common leaflets was performed in 3 children with quadricuspid common AV valve and effectively reduced the regurgitation. The semicircular annuloplasty with a thin Gore-tex graft or the suturing-up of floppy leaflets combined with plasty of the chordae and papillary muscle was carried out in two patients having tricuspid AV valve, and a favourable result was obtained in the semicircular annuloplasty. In mitral AV valvular regurgitation, two patients received the suturing-up of free margins of prolapsed leaflets, and the results were satisfactory. From these results we consider that the semicircular annuloplasty for dilated tricuspid AV valve and the suturing-up of free margins of dilated or floppy leaflets in quadricuspid and bicuspid AV valves are the recommendable procedures. If more than mild AV valvular regurgitation remains after these valvuloplasties, the Kay and/or DeVega annuloplasties should be added for eliminating the regurgitation.