Introduction
Significant atrioventricular valve (AVV) insufficiency, which has been
reported in up to 37% of patients with single-ventricle [1,2], is
one of the major drawbacks of the completion of Fontan circulation.
Congestion in the atrium resulting from atrioventricular regurgitation
should be reduced before and after completion of single-ventricle
circulation. Valve repair is preferable for surgical intervention to the
lesion, because valve and ventricle function can be preserved, and the
risk of complications related to anticoagulant therapy after mechanical
valve implantation might be reduced. Furthermore, an artificial valve
frame fixes the AVV annulus without expected annulus growth after
implantation, which results in the need for repeat artificial valve
replacement depending on the body growth of the patient. Valve
replacement is frequently associated with a moderately high mortality
and various complications, including the need for permanent pacemaker
implantation and repeat valve replacement [3]. However, valve
replacement is often used as treatment for irreparable valve lesions.