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Echocardiographic evaluation and surgical implications of common atrioventricular canal defects with absent or

Avnit Kaur1, Shubhika Srivastava, Irene D Lytrivi

  • 1Division of Pediatric Cardiology, Mount Sinai School of Medicine, New York, New York, USA.

The American Journal of Cardiology
|May 21, 2008
PubMed

Insights

Accurately identifying rare common atrioventricular canal defects without ostium primum defects is crucial for surgical planning. This study details echocardiographic features and surgical challenges associated with these rare cardiac anomalies.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Common atrioventricular canal defects (CAVC) are typically associated with ostium primum (OP) atrial septal defects.
  • CAVC without OP defects are rare but have significant surgical implications.
  • Accurate pre-operative identification is essential for surgical success.

Purpose of the Study:

  • To describe the echocardiographic features of common atrioventricular canal defects with absent or diminutive ostium primum defects.
  • To identify the surgical challenges associated with this rare anomaly.

Main Methods:

  • Retrospective review of echocardiographic database.
  • Inclusion of subjects with CAVC and absent or diminutive OP defects.
  • Review of surgical reports and echocardiograms (pre- and post-operative).

Main Results:

  • Fourteen subjects identified (93% with trisomy 21), with absent (n=6) or diminutive (n=8) OP defects.
  • Malaligned conal septum present in 50% of absent OP defect cases vs. 12.5% of diminutive OP defect cases.
  • Postoperative complications included atrioventricular block (n=4) and mitral regurgitation (moderate n=5, severe n=3).

Conclusions:

  • Echocardiographic features for identifying CAVC with absent/diminutive OP defects are described.
  • Surgical challenges include adequate mitral component exposure and achieving mitral valve competence.
  • Accurate echocardiographic characterization aids in surgical planning and management of these rare defects.

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