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Updated: Aug 10, 2026
Murine Fetal Echocardiography
Published on: February 15, 2013
The surgical anatomy of ventricular septal defects with univentricular atrioventricular connection
R H Anderson1, S Y Ho, B R Wilcox
1Department of Paediatrics, National Heart and Lung Institute, Royal Brompton Hospital, London, United Kingdom.
Insights
This study reviews hearts with univentricular atrioventricular connections, focusing on ventricular septal defects. It categorizes these defects in dominant ventricles and discusses conduction axis positions.
Area of Science:
- Cardiovascular Morphology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Univentricular atrioventricular connections often result from abnormal segmental junction connections.
- These conditions typically involve one dominant ventricle and a smaller, underdeveloped one.
- Ventricular septal defects are integral to the circulatory pathway in many such cases.
Purpose of the Study:
- To analyze and categorize ventricular septal defects in hearts with univentricular atrioventricular connections.
- To clarify the definition of a univentricular heart, excluding those with true ventricular septal defects.
- To describe the morphology of septal defects and the conduction axis in specific groups.
Main Methods:
- Review of literature concerning hearts with univentricular atrioventricular connections.
- Categorization of ventricular septal defects based on dominant ventricle (left or right).
- Analysis of hearts with a single atrioventricular connection to a dominant ventricle.
- Description of conduction axis position in recognized entities.
Main Results:
- Exclusion of hearts with a solitary ventricular chamber and ventricular septal defect from the study.
- Focus on hearts where both atrioventricular junctions connect to a dominant ventricle.
- Inclusion of hearts lacking one atrioventricular connection, with the remaining valve connected to a dominant ventricle.
- Consideration of morphological variations, including overriding of the atrioventricular valve.
Conclusions:
- A precise definition of univentricular hearts excludes those with ventricular septal defects.
- The study provides a morphological classification of septal defects in complex univentricular connections.
- Understanding these morphologies is crucial for diagnosing and managing congenital heart conditions.
Abstract:
Hearts that do not possess one-to-one connections at the segmental junctions almost always produce a univentricular atrioventricular connection. One ventricle is usually large and dominant and the other small, lacking one or two of its components. The ventricular septal deficiency forms part of the circulatory pathway. We take the stance that only hearts that possess a truly solitary ventricular chamber are univentricular. They cannot have a ventricular septal defect, and so are excluded from this study. This review, therefore, is concerned with the morphology of septal defects in hearts in which both atrioventricular junctions are connected exclusively to a dominant left or a dominant right ventricle, and those lacking one atrioventricular connection, where the remaining valve is connected to a dominant ventricle. This morphology in the absence of one atrioventricular connection can be modified when there is overriding of the solitary atrioventricular valve. The ventricular septal defects are analyzed and categorized for the various groups, and the position of the conduction axis is described for the well-recognized entities.
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