|
|
| Year : 2016
| Volume
: 19 | Issue : 4 | Page
: 587-588 |
|
| Transesophageal echocardiography in an atrioventricular septal defect |
|
|
Rohan Magoon, Arindam Choudhury, Amita Sharma, Poonam Malhotra Kapoor
Department of Cardiac Anaesthesia, CTC, AIIMS, New Delhi, India
Click here for correspondence address and
email
| Date of Web Publication | 7-Oct-2016 |
|
|
 |
|
How to cite this article:
Magoon R, Choudhury A, Sharma A, Kapoor PM. Transesophageal echocardiography in an atrioventricular septal defect. Ann Card Anaesth 2016;19:587-8 |
How to cite this URL:
Magoon R, Choudhury A, Sharma A, Kapoor PM. Transesophageal echocardiography in an atrioventricular septal defect. Ann Card Anaesth [serial online] 2016 [cited 2021 Mar 7];19:587-8. Available from: https://www.annals.in/text.asp?2016/19/4/587/191558 |
 Introduction | |  |
Atrioventricular septal defects (AVSDs) characterized by deficient atrioventricular (AV) septation and AV valve anomalies as the endocardial cushions fail to fuse embryonically.
| Terminology | | |
Complete atrioventricular septal defect
Complete AVSD is a primum atrial septal defect (ASD) contiguous with inlet ventricular septal defect (VSD) and common AV valve [Figure 1]. | Figure 1: A primum atrial septal defect contiguous with inlet ventricular septal defect and common atrioventricular valve
Click here to view |
Partial atrioventricular septal defect
Partial AVSD is the absence of an inlet VSD with distinct mitral and tricuspid valves and separate annuli [Figure 2]. The hallmarks are primum ASD and a cleft in the anterior mitral leaflet [Figure 3]. | Figure 2: Absence of an inlet ventricular septal defect with distinct mitral and tricuspid valves and separate annuli
Click here to view |
 | Figure 3: The hallmarks are primum atrial septal defect and a cleft in the anterior mitral leaflet
Click here to view |
| Typical Echocardiographic Characteristics Common to an Atrioventricular Septal Defect | | |
- AV valves inserting at the same level at the cardiac crux due to lack of a normal offset [Video 1]
- Absence of the AV septum [Video 2]
- Unwedging and anterior displacement of the aortic valve [Video 3]
- A scooped-out appearance of the septum resulting in a shorter inlet
- [INLINE:1]
- Counterclockwise rotation of papillary muscles [Video 4]
- Cleft of left AV valve component directed toward the septum resulting in AV valve regurgitation (AVVR) [Video 5].
 | Figure 4: An elongated and narrowed left ventricular outflow tract, a “goose neck” appearance
Click here to view |
| Transesophageal Echocardiography Views Useful for an Atrioventricular Septal Defect: Mid-Esophageal 4c, Transgastric Basal View, Three-Dimensional Atrioventricular Valve Views | | |
Yielding important information on
- Atrial and ventricular septum
- AV valve structure and degree of AVVR
- Chordal insertions of valves
- Classification (Rastelli Type A/B/C based on anterosuperior bridging leaflet morphology)
- Patency of the outflow tracts
- Categorizing as “balanced” or “unbalanced” based on sharing of AV inlet by the ventricles. In an unbalanced AVSD, one ventricle is hypoplastic; transesophageal echocardiography helps predict feasibility of biventricular repair in such cases
- Associated lesions: Left superior vena cava, right ventricular outflow tract obstruction, subaortic stenosis, coarctation, inferior alveolar artery, or posterior descending artery.
- Estimation of pulmonary artery pressures
- AVSD: Readily identified with fetal echocardiography.
Correspondence Address:
Rohan Magoon
Department of Cardiac Anaesthesia, CTC, AIIMS, New Delhi
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0971-9784.191558
[Figure 1], [Figure 2], [Figure 3], [Figure 4] |
|
|
|
|
|
|
|
|
|
