ATRIOVENTRICULAR VALVE COMPETENCE AFTER TAKEDOWN TO IMPROVE EXPOSURE DURING VENTRICULAR SEPTAL-DEFECT REPAIR

Although the atrioventricular valve and its attachments can sometimes obscure the superior margin of a ventricular septal defect, concern fo r valvular competence has made surgeons hesitant to take down the atri oventricular valve. Over a 10-year period, the right atrioventricular valve was taken down to improve exposure for ventricular septal defect repair in 40 patients at our institution, and follow-up echocardiogra phic studies to determine the degree of valvular regurgitation were av ailable in 32. On the basis of the area of the color flow jet, valvula r regurgitation was graded as none in 22 and trivial in 10. Heart bloc k did not develop in any patient, and there were no deaths. Takedown a nd resuspension of the atrioventricular valve is a safe and effective technique that improves exposure for ventricular septal defect repair and does not adversely affect valve competence.