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Echo-morphological correlates in patients with atrioventricular septal defect and common atrioventricular junction

Published online by Cambridge University Press:  13 October 2006

William T. Mahle ,
Girish S. Shirali  and
Robert H. Anderson
William T. Mahle
Affiliation:
Children's Healthcare of Atlanta and the Emory University School of Medicine, Atlanta, Georgia, United States of America
Girish S. Shirali
Affiliation:
Department of Pediatrics (Cardiology), Medical University of South Carolina, Charleston, South Carolina, United States of America
Robert H. Anderson
Affiliation:
Cardiac Unit, University College London Institute of Child Health, London, United Kingdom
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Abstract

It is now well recognized that patients fulfilling the diagnostic criterions for the group of hearts usually described as atrioventricular canal malformations, or atrioventricular septal defects, can present with shunting at atrial level, at both atrial and ventricular levels, and on occasion, with shunting only at ventricular level.1,2 It is also well recognized that, in most instances, the patients with shunting exclusively at atrial level have separate atrioventricular valvar orifices for the right and left ventricles, this arrangement often described as the “ostium primum” variant of atrial septal defect.3 Morphological and echocardiographic studies, however, have shown that, in this variant presumed to represent deficient atrial septation, it is the atrioventricular septal structures, rather than the atrial septum, which are deficient, the phenotypic feature being the presence of a common atrioventricular junction.4,5 In this review, we will show how, using modern day echocardiographic techniques, particularly the newly developed potential for three-dimensional display, it is an easy matter to identify the presence or absence of the common atrioventricular junction, and then to demonstrate the various relationships between the valvar leaflets, the septal structures, and the common junction itself which determine the options for clinical presentation within the group.

Keywords

Common atrioventricular junctionatrioventricular canal3-dimensional echocardiographyleft atrioventricular valve
Type
The Atrioventricular Valves
Information
Cardiology in the Young , Volume 16 , Supplement S3: Controversies and Challenges of the Atrioventricular Junctions and Other Challenges Facing Paediatric Cardiovascular Practitioners and their Patients , September 2006 , pp. 43 - 51
Copyright
© 2006 Cambridge University Press

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