Tláskal T, Povýsilová V
Dĕtské kardiocentrum Fakultní nemocnice Motol, Praha.
Cesk Patol. 1995 Dec;31(4):129-34.
Morphology of atrioventricular septal defect was studied on 73 heart specimens. All of them had a defect of atrioventricular septum and adjoining parts of atrial and ventricular septum, a shortening of inflow parts of both ventricles, a malformation of atrioventricular valves and changed position of aortic valve. There was a great variability of all the studied structures and nearly continuous spectrum of specimens was found as for the ventricles' size, localization and diameter of the defect, communication between atria and ventricles, anatomy of the left ventricle outflow tract as well as the whole atrioventricular valvular apparatus and occurrence of associated heart malformations. A common ostium was formed in 52 cases (71.2%), two separated ostia were found in 21 cases (28.8%) but a continuous transition between both groups was noticed. Both groups showed a great variety of single cusps of atrioventricular valves (in shape, number and anchoring), of papillary muscles and of the size of atrioventricular communication. The finding of frequently associated heart malformations was important from the clinical point of view, especially of the obstructive malformations of the left ventricle. A great morphological variability needs individual surgical solutions, namely reconstruction of valves, closure of septal defects and correction of associated heart malformations.
对73例心脏标本的房室间隔缺损形态进行了研究。所有标本均存在房室间隔及相邻房间隔和室间隔部分的缺损、双心室流入道缩短、房室瓣畸形以及主动脉瓣位置改变。所有研究结构均存在很大变异性，在心室大小、缺损定位和直径、心房与心室之间的交通、左心室流出道解剖结构以及整个房室瓣装置以及相关心脏畸形的发生方面，发现了几乎连续的标本谱。52例（71.2%）形成共同开口，21例（28.8%）发现两个分开的开口，但两组之间存在连续过渡。两组在房室瓣单叶（形状、数量和附着）、乳头肌以及房室交通大小方面均表现出极大差异。从临床角度来看，发现频繁合并的心脏畸形很重要，尤其是左心室梗阻性畸形。巨大的形态学变异性需要个体化的手术解决方案，即瓣膜重建、间隔缺损闭合以及相关心脏畸形的矫正。
