Left ventricular cine-angiocardiography in endocardial cushion defect.

Gotsman, Mervyn S.; Beck, Walter; Schrire, V.

doi:10.1136/hrt.30.2.182

Cited by 13 publications

(2 citation statements)

References 17 publications

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“…Discussion Previous angiocardiographic descriptions of atrio-ventricular defects have concentrated almost exclusively on the abnormal septal 'attachment' of the mitral valve (Baron et al, 1964;Girod et al, 1965;Rastelli et al, 1967;Gotsman et al, 1968;Somerville and Jefferson, 1968;Tenckhoff and Stamm, 1973;Blieden et al, 1974;Rastelli et al, 1976). The free wall attachment as seen in the frontal plane has either been ignored or dismissed as normal (Baron et al, 1964;Somerville and Jefferson, 1968).…”

Section: Differentiation Of Ostium Primum Atrial Septal Defect From Cmentioning

confidence: 96%

Angiocardiographic appearances of atrioventricular defects with particular reference to distinction of ostium primum atrial septal defect from common atrioventricular orifice.

Macartney¹,

Rees²,

Daly³

et al. 1979

Heart

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sUMMARY Preoperative distinction between common atrioventricular orifice and ostium primum atrial septal defect may be difficult.To improve diagnostic accuracy, the right and left ventricular angiocardiograms were reviewed 'blind' in 92 patients with atrioventricular defects. The true diagnosis was known from necropsy or -surgery in 60. Angiocardiograms had been obtained in various projections with or without craniocaudal tilt. Those features thought to distinguish between common orifice and ostium primum were coded, together with the ventricular systolic pressures.Computerised discriminant function analysis identified the following distinguishing features: (1) right ventricular systolic pressure; (2) immediate right ventricular outflow tract opacification from the left ventricle; (3) identification of the anterior attachment of the mitral component; (4) recognition of a single straddling atrioventricular orifice; (5) passage of contrast medium above or below the anterior or posterior bridging leaflets.Feature (3) indicates that in contrast to classic teaching the direct septal attachment of the mitral component does not contribute to the 'gooseneck' in complete atrioventricular defects. The significance of (4) and (5) is that they may be identified from right as well as left ventriculography, and are more likely to be identified in oblique than standard projections. Computerisation produced a correct diagnosis in 92 per cent ofknown cases, and determined precise probabilities of diagnosis in the remainder.The angiographic abnormalities which characterise atrioventricular defects were first described in a classic paper by Baron et al. (1964). These authors ,clearly described the manner in which the abnormal septal attachment of the mitral valve in this condition produces, in the frontal angiocardiogram, the appearance of the 'gooseneck' deformity of the left ventricular outflow tract. It was 10 years before ' Blieden and his colleagues (1974) correctly pointed out that the deformity present was not simply one of the gooseneck (left ventricular outflow tract) but also of the goose (deficiency of the diaphragmatic wall of the left ventricle), but these authors continued to relate the angiocardiographic appearances to the left ventricular septum rather than to its free wall.The logic of these arguments seems clear when applied to the partial defect (ostium primum atrial septal defect). However, it was difficult to understand how the same reasoning could be applied to the diastolic appearances of the complete defect (common atrioventricular orifice), since here there is rarely any direct attachment of the bridging anterior atrioventricular leaflet to the crest of the septum. Such a direct attachment is necessary to visualise atrioventricular leaflets angiocardiographically since it is essential to have a pronounced difference in 40

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Section: Differentiation Of Ostium Primum Atrial Septal Defect From Cmentioning

confidence: 96%

Angiocardiographic appearances of atrioventricular defects with particular reference to distinction of ostium primum atrial septal defect from common atrioventricular orifice.

Macartney¹,

Rees²,

Daly³

et al. 1979

Heart

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“…A typical "goose neck" deformity of the LVOT can also be seen using a right parasternal long axis 5 chambers view (Figure 19-63) [138]. This deformation, referring to the angiocardiographic appearance initially described, results from the abnormal anterior and apical displacement of the mitral valve, encroaching on the posterior and medial walls of the outflow tract, thus narrowing and elongating the lumen [139]. The causes of this deformity are probably more complex than abnormal position and attachment of the mitral valve; left ventricular geometry factors also may be involved [138].…”

Section: Echocardiographic Aspects Bidimensional Echocardiographymentioning

confidence: 92%

Congenital Cardiopathies

Bussadori¹,

Pradelli²

2015

Clinical Echocardiography of the Dog and Cat

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Left Ventricular Outflow Tract Obstruction in Atrioventricular Septal Defects: A Pathologic and Morphometric Evaluation

Gallo

Formigari

Hokayem

et al. 1991

Clinical Cardiology

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Summary: Subaortic stenosis has been described with increasing frequency as an ominous feature of atrioventricular septal defect (AVSD), especially following surgical correction of the anomaly in non-Down's syndrome patients. In order to study the surgical anatomy of the left ventricular outflow tract in this malformation, 48 hearts featuring AVSD were examined. Obstructive lesions wcre classified into unequivocal forms (class A, 13.5%) and potential ones (class B, 10.8%). In the remaining hearts (class C, 75.7%) no obstruction was noted. In class A, subaortic stenosis was due to exaggeration of the anticipated anomalous arrangement of atrioventricular valve tensor apparatus, to the persistence of a subaortic muscular infundibulum, and to a discrete fibrous diaphragm. A potential for subaortic stenosis is provided by the unwedged position of the aortic valve. The left ventricular outflow tract is transformed into a long, forward-displaced fibromuscular channel. Morphometric analysis showed in AVSD (with both common annulus and separate orifices) a significantly (p

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Left ventricular cine-angiocardiography in endocardial cushion defect.

Cited by 13 publications

References 17 publications

Angiocardiographic appearances of atrioventricular defects with particular reference to distinction of ostium primum atrial septal defect from common atrioventricular orifice.

Angiocardiographic appearances of atrioventricular defects with particular reference to distinction of ostium primum atrial septal defect from common atrioventricular orifice.

Congenital Cardiopathies

Left Ventricular Outflow Tract Obstruction in Atrioventricular Septal Defects: A Pathologic and Morphometric Evaluation

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