[Morphological and angiocardiographic study of atrioventricular septal defects]

A group of post-mortem specimens of 82 hearts with a defect of the atrioventricular septum (atrioventricular canal) was retrospectively examined with special attention to the morphology of the defect in relation to the left atrioventricular anastomosis. In 42 preparations the finding was compared with previous angiocardiography and post-mortally with X-ray pictures of the specimens. Correlation of the findings revealed malformation of the left atrioventricular orifice as part of a complex malformation affecting the valvular apparatus in conjunction with the atrioventricular septal defect. In the very variable anatomical morphology a major part is played by the superior cusp of the left atrioventricular anastomosis. The relationship of the superior cusp to the outflow tract of the left ventricle and to the atrioventricular septal defect has an impact on the variability of the angiocardiographic picture, and last but not least, also on the results of surgical treatment. The anteroposterior, left oblique and hepatoclavicular projections are optimal for visualization of the anomaly.