Understanding atrioventricular septal defect: anatomoechocardiographic correlation.

OBJECTIVE: Correlate the anatomic features of atrioventricular septal defect with echocardiographic images. MATERIALS AND METHODS: Sixty specimen hearts were studied by sequential segmental analysis. Echocardiograms were performed on 34 patients. Specimen hearts with findings equivalent to those of echocardiographic images were selected in order to establish an anatomo-echocardiographic correlation. RESULTS: Thirty-three specimen hearts were in situs solitus, 19 showed dextroisomerism, 6 were in situs inversus and 2 levoisomerism. Fifty-eight had a common atrioventricular valve and 2 had two atrioventricular valves. Rastelli types were determined in 21 hearts. Nine were type A, 2 intermediate between A and B, 1 mixed between A and B, 4 type B and 5 type C. Associated anomalies included pulmonary stenosis, pulmonary atresia atrial septal defect, patent ductus arteriosus and anomalous connection of pulmonary veins. Echocardiograms revealed dextroisomerism in 12 patients, situs solitus in 11, levoisomerism in 7 and situs inversus in 4. Thirty-one patients had common atrioventricular valves and three two atrioventricular valves. Rastelli types were established in all cases with common atrioventricular valves; 17 had type A canal defects, 10 type B, 3 intermediate between A and B, 1 mixed between A and B and 3 type C. Associated anomalies included regurgitation of the atrioventricular valve, pulmonary stenosis, anomalous connection of pulmonary veins, pulmonary hypertension and pulmonary atresia. CONCLUSION: Anatomo-echocardiographic correlation demonstrated a high degree of diagnostic precision with echocardiography.

Atrioventricular septal defect: quantitative anatomy of the right ventricle.

In 19 human fetal and newborn hearts with atrioventricular septal defect (AVSD), not associated with other anomalies, the two ventricles were studied morphometrically. A total of 17 different parameters were studied: nine in the right ventricle and eight in the left. In the right ventricle we analyzed ventricular wall thickness, length of right ventricular inflow and outflow tracts, and volume of right ventricular inflow and outflow tracts. The data for these parameters were compared with the patterns of normality published previously, and the volumetric data were compared with patterns of normality published previously by us. The ventricular inflow tract was shorter than the outflow tract, the difference being especially significant in the left ventricle. The length of the diaphragmatic wall of the heart in both the right and left ventricle was equal to the sum of the length of the inflow tract and the thickness of the ventricular wall at the apex.

Embriología de la persistencia del canal auriculoventricular común / Embryology of the patent common atrioventricular canal

El cojín inferior del canal atrioventricular da origen al septum que separa a ambos orificios auriculoventriculares y al ventrículo izquierdo de la aurícula derecha (septum atrioventricular), a la región adyacente a este septum de los tabiques interatrial e interventricular, y a la valva septal de la tricúspide y al segmento de la valva anterior de la mitral que se insertan en el tabique. Si el cojín inferior del canal atrioventricular no se desarrollara, existiría un anillo único mitrotricuspídeo, un defecto septal que comunicaría las cuatro cavidades cardíacas entre sí, y la ausencia de la valva septal de la tricúspide y del segmento de la valva anterior de la mitral que se inserta en el septum; cuadro anatómico específico de la persistencia del canal auriculoventricular común

Embriología de la persistencia del canal auriculoventricular común / Embryology of the patent common atrioventricular canal

El cojín inferior del canal atrioventricular da origen al septum que separa a ambos orificios auriculoventriculares y al ventrículo izquierdo de la aurícula derecha (septum atrioventricular), a la región adyacente a este septum de los tabiques interatrial e interventricular, y a la valva septal de la tricúspide y al segmento de la valva anterior de la mitral que se insertan en el tabique. Si el cojín inferior del canal atrioventricular no se desarrollara, existiría un anillo único mitrotricuspídeo, un defecto septal que comunicaría las cuatro cavidades cardíacas entre sí, y la ausencia de la valva septal de la tricúspide y del segmento de la valva anterior de la mitral que se inserta en el septum; cuadro anatómico específico de la persistencia del canal auriculoventricular común (AU)