Repair of left atrioventricular disruption after mitral valve replacement using extracorporeal life support system for effective ventricular unloading.

Atrioventricular (AV) disruption is a rare but fatal complication after prosthetic mitral valve replacement. Surgical management is controversial and ranges from epicardial tissue sealing to open repair using autologous or xenogenic patch techniques to autotransplantation of the heart. We report the successful repair of an AV disruption Type I using an extracorporeal life support (ECLS) system for effective ventricular unloading followed by epicardial patch closure. The surgical management of AV disruption benefits from the use of ECLS, as it allows effective decompression of the heart without requiring full heparinization.