Heart 1999;81:199-205 ( February )
Cross sectional echocardiographic assessment of the extent of the atrial septum relative to the atrioventricular junction in atrioventricular septal defect
a Paediatrics,
National Heart and Lung Institute, Royal Brompton Campus, Imperial
College School of Medicine, Dovehouse Street, London SW3 6LY, UK, b Paediatric Cardiology, Fundação
Hospitalar de Brasilia, Brasil, c Cattedra di Cardiologia, University of Padova,
Italy
Correspondence to: Professor Anderson. email: r.anderson{at}ic.ac.uk
Accepted for publication 21 September 1998
Objective
To
study patients with atrioventricular septal defect to determine the
pathognomonic morphological features of the lesion and the relation
between the septal structures and the atrioventricular junction.
Setting Tertiary
level paediatric cardiology centre.
MethodsCross
sectional echocardiograms from 60 patients were reviewed using
qualitative and quantitative analysis. The unifying feature was the
presence of a common atrioventricular junction. The overall dimensions
of the septal defect were determined and related to the plane of the
common junction; the extent of both the atrial and the ventricular
septal components was then measured according to the site of closure of
the bridging leaflets.
ResultsIn 48 cases,
the common junction was guarded by a common valvar orifice, but in 12 cases there were separate right and left valvar orifices. Irrespective
of the valvar morphology, no significant difference was found between
the groups in terms of the dimensions of the atrial and ventricular
septal components. In all patients, the hole permitting shunting at
atrial level extended below the plane of the atrioventricular junction,
with a variable position of the leading edge of the atrial septum itself.
ConclusionsThe
atrioventricular junction is a common structure irrespective of valvar
morphology. In spite of the presence of unequivocal shunting at atrial
level, the atrial septum is usually a well formed structure, even
extending in some below the level of the common atrioventricular junction.
© 1999 by Heart
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