Cabrera A, Pastor E, Galdeano J M, Modesto C, Cabrera J A, Alcibar J, Peña R
Department of Paediatric Cardiology, Children's Hospital Cruces, Vizcaya, Spain.
Int J Cardiol. 1990 Jul;28(1):19-23. doi: 10.1016/0167-5273(90)90004-o.
Between 1983-1988 cross-sectional echocardiography was performed in 63 patients having an atrioventricular septal defect with common atrioventricular orifice. We excluded from this study all those patients with separate right and left orifices ("ostium primum" defects), those with isomerism of the right and left atrial appendages, those with univentricular atrioventricular connexions and those with discordant atrioventricular and ventriculo-arterial connexions. Parasternal long- and short-axis views, apical 4-chamber views and subcostal long-axis views were employed in all patients. In the last 26 cases, we also obtained the subcostal short-axis view. Nineteen patients showed ventricular dominance, with the right ventricle being dominant in 15. Ten patients had an associated defect in the oval fossa, while the atrial septum was partially or completely absent in the other 53. A ventricular septal defect was observed in all, but it was small in 10 and multiple in 2. Attachments of the superior and inferior bridging leaflets to the crest or the right side of the ventricular septum were seen in 32 cases. The inferior leaflet was hypoplastic in 19 patients. There was narrowing of the left ventricular outflow tract in 8 patients, and obstruction of the right ventricular outflow tract in 3. Abnormal attachment of the right portion of the common valvar orifice was present in 2 cases. A solitary papillary muscle supporting the left ventricular component of the common valve was seen in 6 cases producing a parachute-like arrangement. Our study shows that cross-sectional echocardiography is an excellent technique for the analysis of this anomaly.
1983年至1988年间，对63例患有房室间隔缺损合并共同房室口的患者进行了横断面超声心动图检查。我们将所有具有单独的左右房室口（“原发孔”缺损）、左右心耳异构、单心室房室连接以及房室和心室动脉连接不一致的患者排除在本研究之外。所有患者均采用胸骨旁长轴和短轴视图、心尖四腔视图和肋下长轴视图。在最后26例患者中，我们还获得了肋下短轴视图。19例患者表现为心室优势，其中15例以右心室为主。10例患者卵圆窝存在相关缺损，而在其他53例患者中，房间隔部分或完全缺失。所有患者均观察到室间隔缺损，但其中10例较小，2例为多发。32例患者可见上、下桥瓣叶附着于室间隔嵴或右侧。19例患者下瓣叶发育不全。8例患者左心室流出道狭窄，3例患者右心室流出道梗阻。2例患者共同瓣膜口右侧附着异常。6例患者可见一个单独的乳头肌支撑共同瓣膜的左心室部分，形成降落伞样结构。我们的研究表明，横断面超声心动图是分析这种异常的一项出色技术。
