Soto B, Ceballos R, Nath P H, Bini R M, Pacifico A D, Bargeron L M
Int J Cardiol. 1985 Nov;9(3):323-39. doi: 10.1016/0167-5273(85)90031-2.
An analysis of 6 patients with overriding atrioventricular valve was performed in order to correlate the anatomic and angiographic features of this malformation. The atrial arrangement was usual (situs solitus) in each patient. The ventricular chambers were normally related in 4 and the mirror image of normal in 2. The atrioventricular connexion was concordant in parallel fashion in 4, discordant in 1 and double inlet left ventricle in 1 heart. In 2 of 4 hearts with concordant atrioventricular connexion, the right atrioventricular valve (tricuspid) overrode the septum and connected partially to the left ventricle. In 2, the left atrioventricular valve (mitral) overrode the septum and partially connected with the right ventricle. One heart with discordant atrioventricular connexion had its right atrioventricular valve (mitral) overriding the septum. The remaining heart with double inlet left ventricle had an overriding left atrioventricular valve. Each overriding atrioventricular valve had its "septal" leaflet (the one committed to the contralateral ventricle) divided into 2 segments by a large cleft. Ventricular septal defects at different locations were present in all cases. The ventriculoarterial connexion was double outlet right ventricle in 5 patients and was discordant in 1. Malalignment of the atrial and ventricular septa was present to some degree in all cases. This was well depicted on ventriculograms in four chamber view in those with an overriding tricuspid valve. It was not detected in those with an overriding mitral valve. The displaced leaflets of the overriding and/or stradding valve had a vertical motion on cineangiograms similar to those observed in atrioventricular septal defects. Abnormal morphology and motion of the septal leaflet of the overriding atrioventricular valve and malalignment of the atrial and ventricular septal structures were the most important angiographic findings in this series.
对6例房室瓣骑跨患者进行了分析，以关联这种畸形的解剖学和血管造影特征。每位患者的心房排列均正常（心房正位）。4例患者的心室腔关系正常，2例呈正常镜像关系。4例患者的房室连接呈平行一致，1例不一致，1例为双入口左心室。在4例房室连接一致的心脏中，2例右房室瓣（三尖瓣）骑跨于室间隔并部分与左心室相连。另外2例中，左房室瓣（二尖瓣）骑跨于室间隔并部分与右心室相连。1例房室连接不一致的心脏，其右房室瓣（二尖瓣）骑跨于室间隔。其余1例双入口左心室的心脏有一个骑跨的左房室瓣。每个骑跨的房室瓣其“间隔”瓣叶（即与对侧心室相连的瓣叶）被一个大裂隙分为两段。所有病例均存在不同部位的室间隔缺损。5例患者的心室动脉连接为右心室双出口，1例不一致。所有病例均存在一定程度的房间隔和室间隔排列不齐。在三尖瓣骑跨的患者中，四腔心视图的心室造影能很好地显示这一情况。二尖瓣骑跨的患者则未检测到。骑跨和/或跨越瓣膜的移位瓣叶在电影血管造影上有垂直运动，类似于房室间隔缺损中观察到的情况。骑跨房室瓣间隔瓣叶的形态和运动异常以及房间隔和室间隔结构的排列不齐是本系列最重要的血管造影表现。
