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Cross sectional echocardiography for recognition of ventricular topology in atrioventricular septal defect
J S Carvalho1, M L Rigby, E A Shinebourne
1Department of Paediatric Cardiology, Brompton Hospital, London.
Insights
This study on children with atrioventricular septal defects found ventricular topology varies, especially in atrial isomerism. Understanding this spatial orientation is crucial for surgical planning and can be identified using echocardiography.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Cardiac Imaging
Background:
- Atrioventricular septal defects (AVSDs) are common congenital heart abnormalities.
- Understanding ventricular topology is vital for surgical planning in pediatric cardiac interventions.
- Spatial orientation of ventricles can influence cardiac function and surgical outcomes.
Purpose of the Study:
- To determine the spatial orientation (topology) of ventricles in children with atrioventricular septal defects.
- To investigate the relationship between atrial arrangement and ventricular topology in AVSDs.
- To assess the utility of cross-sectional echocardiography in identifying ventricular topology in this population.
Main Methods:
- Review of cross-sectional echocardiograms from 150 children diagnosed with atrioventricular septal defects.
- Classification of atrial arrangement into usual atrial arrangement (situs solitus) and atrial isomerism.
- Analysis of ventricular topology using established patterns (right hand and left hand).
Main Results:
- In 125 children with situs solitus, ventricular topology predominantly showed the right hand pattern.
- In 25 children with atrial isomerism, 48% exhibited left hand ventricular topology, a higher prevalence than expected.
- No significant correlation was found between ventricular topology and the number of atrioventricular valves or ventriculoarterial connection.
Conclusions:
- Ventricular topology in children with AVSDs can be variable, particularly in cases of atrial isomerism.
- Knowledge of ventricular topology is important for surgical considerations, including the disposition of conducting tissue.
- Cross-sectional echocardiography is an effective method for prompt recognition of ventricular topology in children with AVSDs.
Abstract:
The cross sectional echocardiograms of 150 children with atrioventricular septal defects were reviewed to determine the spatial orientation of the ventricles. In 125 cases with usual atrial arrangement (situs solitus), ventricular topology showed the right hand pattern. Of the 25 patients with atrial isomerism, 13 had similar right hand topology but 12 (48%) had the left hand pattern. This finding was more common in hearts in the right side of the chest (dextrocardia), but there was no significant correlation between ventricular topology and number of atrioventricular valves or the ventriculoarterial connection. In part because of inferences for disposition of the conducting tissue, knowledge of ventricular topology is important when operation for atrioventricular septal defects is considered. Ventricular topology can be promptly recognised by cross sectional echocardiography.