Atrioventricular Valve Replacement With Monovalvatation Technique for Single Ventricle With Two Atrioventricular Valve Orifices.

Atrioventricular valve (AVV) replacement for patients with single-ventricle physiology and 2 AVV orifices can be technically challenging when both annuli are too small to place adequately sized prosthesis. We report 2 adult Fontan patients who underwent AVV replacement with monovalvatation technique, in which 2 AVV orifices were integrated into a single annulus by incising an interventricular septum between 2 AVV orifices. They had prior AVV replacement with relatively small prosthesis or AVV repair with complete annuloplasty in childhood. Postoperative courses were uneventful, with good prosthetic function. This technique can be an effective surgical option in such anatomically challenging cases.