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Double orifice left atrioventricular valve—diagnosis and management of an unexpected lesion

Published online by Cambridge University Press:  19 August 2008

David B. Brieger
Affiliation:
From The Adolph Basser Institute of Cardiology, Royal Alexandra Hospital for Children, Sydney
Cameron Ward
Affiliation:
From The Adolph Basser Institute of Cardiology, Royal Alexandra Hospital for Children, Sydney
Stephen G. Cooper
Affiliation:
From The Adolph Basser Institute of Cardiology, Royal Alexandra Hospital for Children, Sydney
Graham R. Nunn
Affiliation:
From The Adolph Basser Institute of Cardiology, Royal Alexandra Hospital for Children, Sydney
Timothy B. Cartmill
Affiliation:
From The Adolph Basser Institute of Cardiology, Royal Alexandra Hospital for Children, Sydney
Gary F. Sholler*
Affiliation:
From The Adolph Basser Institute of Cardiology, Royal Alexandra Hospital for Children, Sydney
*
Dr. G. Sholler, The Adolph Basser Institute of Cardiology, Royal Alexandra Hospital for Children, PO Box 34, Camperdown, Sydney 2050, Australia.

Abstract

Double orifice left atrioventricular valve is an uncommon condition. This paper describes 10 consecutive patients with the anomaly encountered over 20 months. Diagnosis was assisted by cross-sectional echocardiography and supplementary color Doppler, often requiring non-standard views and a high index of suspicion. There were three anatomical variants—those in which the orifices were equal in size (three of 10 patients), those in which they were unequal and associated with an atrioventricular septal defect (four of 10 patients), and those in which they were unequal in the absence of an atrioventricular septal defect (three of 10 patients). The unequal orifice in both anatomical situations was frequently complicated by valvar regurgitation (six of seven patients). Conservative repair was possible in three of the four patients requiring surgery to the left atrioventricular valve. This condition should be thought of more often in the differential diagnosis of left atrioventricular regurgitation in childhood.

Type
Original Manuscripts
Copyright
Copyright © Cambridge University Press 1995

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References

1.Wakai, C, Edwards, J. Pathological study of persistent common atrioventricular canal. Am Heart J 1956; 56: 779790.CrossRefGoogle Scholar
2.Somerville, J, Warnes, C. Double mitral valve orifice in atrioventricular defects. Br Heart J 1983; 49: 5964.Google Scholar
3.Wigle, E. Duplication of the mitral valve. Br Heart J 1957; 19: 296300.Google Scholar
4.Rosenberg, J, Roberts, W. Double orifice mitral valve. Study of the anomaly in two calves and a summary of the literature in humans. Arch Path 1968; 86: 7780.Google Scholar
5.Ilbawi, M, Idriss, F, DeLeon, S, Riggs, T, Muster, A, Berry, T, Paul, M. Unusual mitral valve abnormalities complicating surgical repair of endocardial cushion defects. J Thorac Cardiovasc Surg 1983; 85: 697704.CrossRefGoogle ScholarPubMed
6.Ebels, T, Anderson, R, Devine, W, Debich, D, Penkoske, P, Zuberbuhler, J. Anomalies of the left atrioventricular valve and related septal morphology in atrioventricular septal defects. J Thorac Cardiovasc Surg 1990; 99: 299307.CrossRefGoogle ScholarPubMed
7.Kirklin, J, Blackstone, E, Bageron, L, Pacifico, A, Kirklin, J. The repair of atrioventricular septal defects in infancy. Int J Cardiol 1986; 13: 333351.Google Scholar
8.Trowitzsch, E, Bano-Rodrigo, A, Burger, B, Colan, S, Sanders, S. Two-dimensional echocardiographic findings in double orifice mitral valve. J Am Col Cardiol 1985; 6: 383387.Google Scholar
9.Kron, J, Standerfer, R, Starr, A. Severe mitral regurgitation in a woman with a double orifice mitral valve. Br Heart J 1986; 55: 109111.CrossRefGoogle Scholar
10.Mercer, J, Tubbs, O. Successful surgical management of double mitral valve with subaortic stenosis. J Thorac Cardiovasc Surg 1974; 67: 440442.Google Scholar
11.Sharma, S, Loya, YS, Daxini, BV. Coarctation of the aorta with unusual association of diverticulum of the left ventricle and double orifice mitral valve. Int J Cardiol 1991; 30: 113115.CrossRefGoogle ScholarPubMed
12.Majid, AA. Double orifice mitral valve: a case report and review of management.J Cardiovasc Surg Torino 1991; 32: 837839.Google Scholar