Valve-Sparing Atrioventricular Valve Replacement in a Single-Ventricle Infant: Preserving the Entire Leaflet-Chordal Complex.

We report a 4-month-old, 3.7-kg girl with asplenia, single ventricle physiology, a common atrioventricular valve, and severe regurgitation after repair, along with moderately depressed ventricular function. She underwent supra-annular valve replacement with a 16-mm mechanical prosthesis and 18-mm expanded polytetrafluoroethylene graft, preserving the entire valve leaflets and subvalvular apparatus. Postoperative imaging showed no inflow/outflow obstruction and preserved ventricular function. She subsequently underwent a bidirectional Glenn shunt and is currently awaiting the Fontan procedure. This approach may be a valuable surgical option in similar infants with atrioventricular valve regurgitation and ventricular dysfunction.