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Relationship between scooping of the ventricular septum, morphology of the inferior bridging leaflet and electrocardiographic findings in atrioventricular septal defect with common valvar orifice

Published online by Cambridge University Press:  19 August 2008

Kiyoshi Suzuki ,
Katsuhiko Tatsuno ,
Shigekazu Mimori ,
Yasuo Murakami ,
Katsuhiko Mori ,
Yukihiro Takahashi  and
Toshio Kikuchi
Kiyoshi Suzuki*
Affiliation:
From the Department of PediatricsSakakibara Heart Institute, Tokyo
Katsuhiko Tatsuno
Affiliation:
Department of Cardiac Surgery, Sakakibara Heart Institute, Tokyo
Shigekazu Mimori
Affiliation:
From the Department of PediatricsSakakibara Heart Institute, Tokyo
Yasuo Murakami
Affiliation:
From the Department of PediatricsSakakibara Heart Institute, Tokyo
Katsuhiko Mori
Affiliation:
From the Department of PediatricsSakakibara Heart Institute, Tokyo
Yukihiro Takahashi
Affiliation:
Department of Cardiac Surgery, Sakakibara Heart Institute, Tokyo
Toshio Kikuchi
Affiliation:
Department of Cardiac Surgery, Sakakibara Heart Institute, Tokyo
*
Dr. Kiyoshi Suzuki, Department of Pediatrics, Sakakibara Mean Institute, 2-5-4 Yoyogi, Shibuya-ku, Tokyo 151, Japan. Tel. 81-3-3375-3111; Fax. 81-3-3375-9218.
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Abstract

We described previously that the degree of deficiency of the ventricular septum (scooping) affects electrocardiographic findings in atrioventricular septal defect with separate right and left atrioventricular orifices. The aim of this study was to clarify the clinicomorphological relationships of the degree of scooping, the precise morphology of the atrioventricular valve, and electrocardiographic findings in hearts having a common atrioventricular orifice. In 63 patients with usual atrial arrangement, the outlet, scoop and inlet dimensions of the ventricular septum were measured by biplanar cineangiography and were compared with the body surface area. The scoop/outlet ratio and inlet/outlet ratio were also compared with the body surface area, atrioventricular valvar morphology, electrocardiographic findings, and severity of regurgitation of the atrioventricular valve. The results showed that the three individual dimensions of the septum correlated significantly with the body surface area, even though the scoop/outlet ratio and inlet/outlet ratio did not. A correlation was found between the scoop/outlet ratio and the degree of left axis deviation on the electrocardiogram (r=0.74, p<0.001). In 16 patients with division of the inferior bridging leaflet, there was a lower scoop/outlet ratio than in the remaining 37 with an undivided bridging leaflet (p<0.01). Of 24 patients with counterclockwise rotation in the horizontal loop of the vectorcardiogram, 22 had an undivided inferior bridging leaflet (p<0.01). The morphology of the superior bridging leaflet, in contrast, was not associated with the scoop/outlet ratio, and neither was the severity of valvar regurgitation. We conclude that the degree of scooping of the ventricular septum is related not only to electrocardiographic findings, but also to the morphology of the inferior bridging leaflet in atrioventricular septal defect with common atrioventricular orifice.

Keywords

Atrioventricular septal defectclinicomorphological correlationdegree of scooping of the ventricular septumcineangiogramelectrocardiogram
Type
Original Manuscripts
Information
Cardiology in the Young , Volume 6 , Issue 1 , January 1996 , pp. 37 - 43
Copyright
Copyright © Cambridge University Press 1996

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