Atrioventricular Valve Repair in Patients with Univentricular Circulation

Atrioventricular valve (AVV) disease remains a challenge in the management of patients with congenital heart disease, particularly those with single ventricle palliation. Within this group, atrioventricular valve (AVV) disease remains the Achilles heel of long-term successful palliation. In recent years we have learned how AVV pathology is detrimental to late survival, as well as how challenging it can be to obtain a competent and durable repair. In this expert review we outline strategies for AVV repair depending on AVV morphology: mitral, tricuspid, or common atrioventricular valve. Given the broad scope of AVV pathology, a large number of tools are needed in a congenital cardiac surgeon's armamentarium to successfully treat these patients. Many of these techniques have been successfully employed in patients with biventricular physiology, but can have applicability to those with single ventricle palliation.