**13. Conclusions**

AVSDs are a group of disorders with deficient AV septum and abnormal AV valve morphology. It is the most common defect in Down syndrome. The definitive surgical repair has excellent outcomes in balanced AVSDs. For unbalanced AVSDs, it is a complex decision-making process and their repairs are usually categorized to single, one and half or bi- ventricular repair. For a select subset of patients, ventricular recruitment procedures improve the candidacy for future bi-ventricular circulation. Patients with Down syndrome should have similar surgical strategies as that of non-Down syndrome patients. The most common reason for reoperation is left AV valve regurgitation.
