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Echocardiogram in common (single) ventricle: angiographic-anatomic correlation
Insights
Common ventricle, a rare congenital heart defect, is diagnosed using echocardiography. This imaging technique effectively identifies key anatomical features, aiding in surgical planning for this complex condition.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Medical Imaging
Background:
- Common ventricle is a rare congenital anomaly characterized by a single ventricular chamber receiving blood from two atrioventricular (A-V) valves or a common A-V valve.
- Accurate diagnosis is crucial for effective management and surgical intervention.
Purpose of the Study:
- To evaluate the role of echocardiography in diagnosing common ventricle.
- To describe the specific echocardiographic features associated with common ventricle, both with two A-V valves and a common A-V valve.
Main Methods:
- Echocardiographic features were analyzed in 55 patients diagnosed with common ventricle via cardiac catheterization, operation, or autopsy.
- Specific echocardiographic findings were correlated with the presence of two A-V valves or a single common A-V valve.
Main Results:
- Echocardiography identified key features including simultaneous A-V valve echoes without septal echoes, absence of the ventricular septal echo, visualization of outflow chambers, and continuity between the posterior A-V valve and great artery.
- In cases with a common A-V valve, echocardiography showed a single posterior A-V valve with large diastolic excursion and absence of a second A-V valve echo.
- Postoperative echocardiography demonstrated prosthetic septa dividing the common ventricle.
Conclusions:
- Echocardiography is a valuable tool for assessing ventricular anatomy in common ventricle.
- The distinct echocardiographic findings aid in differentiating subtypes and guiding surgical correction.
- Echocardiography plays an important role in the preoperative and postoperative assessment of this complex congenital cardiac defect.
Abstract:
Common ventricle is a rare congenital anomaly in which the ventricular chamber receives blood from two separate atrioventricular (A-V) valves or a common A-V valve. Diagnosis of common ventricle was established in 55 patients aged 3 months to 33 years (mean 10 years) at cardiac catheterization in all 55 and at operation or autopsy in 24. In common ventricle with two angiographically demonstrable A-V valves (47 patients), the echocardiographic features included: (1) simultaneous recording (in the same sonic beam with the transducer held stationary) of the echoes of an anterior and a posterior A-V valve without an intervening septal echo (45 of 47 patients); (2) absence, on a base to apex scan, of the ventricular septal echo in the usual position separating the A-V valves (47 of 47 patients); (3) recording, in patients with common ventricle and outflow chamber, of this small outflow chamber anterior to the A-V valves (20 of 23 patients); and (4) recording of echographic continuity of the posterior A-V valve and great artery (27 of 31 patients). In common ventricle with a common A-V valve (8 patients), the echocardiographic features included: (1) a single demonstrable A-V valve, located posteriorly in the ventricle, which showed a large amplitude of excursion during diastole; and (2) absence of a second A-V valve echo or ventricular septal echo. Eight patients were studied postoperatively after surgical correction by ventricular septation. Echographic features included visualization of a prosthetic septum that produced a dense echo and divided the common ventricle into "right" and "left" ventricular chambers. This septum had a large excursion anteriorly during systole. Because common ventricle is now amenable to surgical correction, echocardiography should play an important role in assessment of ventricular anatomy in this complex congenital cardiac defect.