Echocardiography in endocardial cushion defects: a preoperative and postoperative study

Echocardiographic studies were performed on 14 patients with endocardial cushion defects of different anatomic varieties. Four patients were studied again after operation. Patients with partial atrioventricular canal (PAVC) showed multiple systolic echoes on mitral valve echogram, with significant mitral-septal apposition in diastole. The left ventricular outflow (LVO) appeared significantly narrowed. The septal motions were paradoxic. After corrective operation, an increase in the width of the LVO was noted and mitral-septal apposition appeared to be less pronounced. Multiple systolic echoes, however, reappeared and persisted. The echocardiograms in patients with complete atrioventricular canal (CAVC) were characterized by wide excursion of an apparent single atrioventricular valve. The echoes of the mitral component of the common anterior leaflet moved anteriorly into the right ventricular cavity and overshadowed the tricuspid component in diastole. In addition, patients with CAVC and divided and medially attached common anterior leaflets had solitary mitral and tricuspid echograms. This feature differentiates this group of patients from those patients with CAVC with undivided freefloating common anterior leaflet.