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. 1993 Aug;70(2):180–184. doi: 10.1136/hrt.70.2.180

Atypical form of atrioventricular septal defect without left axis deviation: relation between morphology and unusual QRS axis.

K Suzuki 1, Y Murakami 1, K Tatsuno 1, Y Takahashi 1, T Kikuchi 1, K Mori 1, S Mimori 1
PMCID: PMC1025282  PMID: 8038031

Abstract

OBJECTIVE--To clarify the morphological features relating to an intermediate axis or a right axis deviation in atrioventricular septal defect (AVSD). SUBJECTS--135 patients with typical AVSD and with nine patients with atypical AVSD, characterised by a well formed atrial septum, a milder downward displacement of the atrioventricular valves, and a shorter length of the ostium primum defect. MAIN OUTCOME MEASURES--Relation between morphology and electrocardiographic and vectorcardiographic findings; prevalence of Down's syndrome and of other cardiac anomalies. RESULTS--All nine patients with atypical AVSD had an unusual mean frontal QRS axis compared with six of the 135 patients (4%) with typical AVSD (p < 0.01). All eight patients who underwent the vector analyses showed atypical movement of the QRS loop--that is, an initial left inferior movement in the frontal loop (eight patients) and counter-clockwise rotation in the sagittal loop (seven). The corresponding values for 119 patients with typical AVSD were 20 and 22 patients (p < 0.01). Seven patients with atypical AVSD (78%) and 55 (41%) with typical AVSD had Down's syndrome (p < 0.05). None of the twenty one patients with additional cardiac anomalies had atypical AVSD, an unusual QRS axis, or unusual movement in the QRS loop. CONCLUSIONS--The atypical morphology, supposedly related to the degree of posteroinferior displacement of the conduction system, was one of the causes of unusual movement of the QRS loop in AVSD.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Boineau J. P., Moore E. N., Patterson D. F. Relationship between the ECG, ventricular activation, and the ventricular conduction system in ostium primum ASD. Circulation. 1973 Sep;48(3):556–564. doi: 10.1161/01.cir.48.3.556. [DOI] [PubMed] [Google Scholar]
  2. Feldt R. H., DuShane J. W., Titus J. L. The atrioventricular conduction system in persistent common atrioventricular canal defect: correlations with electrocardiogram. Circulation. 1970 Sep;42(3):437–444. doi: 10.1161/01.cir.42.3.437. [DOI] [PubMed] [Google Scholar]
  3. Fournier A., Young M. L., Garcia O. L., Tamer D. F., Wolff G. S. Electrophysiologic cardiac function before and after surgery in children with atrioventricular canal. Am J Cardiol. 1986 May 1;57(13):1137–1141. doi: 10.1016/0002-9149(86)90688-0. [DOI] [PubMed] [Google Scholar]
  4. Gutgesell H. P., Huhta J. C. Cardiac septation in atrioventricular canal defect. J Am Coll Cardiol. 1986 Dec;8(6):1421–1424. doi: 10.1016/s0735-1097(86)80317-5. [DOI] [PubMed] [Google Scholar]
  5. Marino B., Vairo U., Corno A., Nava S., Guccione P., Calabrò R., Marcelletti C. Atrioventricular canal in Down syndrome. Prevalence of associated cardiac malformations compared with patients without Down syndrome. Am J Dis Child. 1990 Oct;144(10):1120–1122. doi: 10.1001/archpedi.1990.02150340066025. [DOI] [PubMed] [Google Scholar]
  6. Matsuo N., Oshima M., Masuyoshi N., Shimizu K., Okada R. Major and minor anomalies in Japanese children with Down's syndrome. Jpn Heart J. 1972 Jul;13(4):307–316. doi: 10.1536/ihj.13.307. [DOI] [PubMed] [Google Scholar]
  7. Seo K., Ishihara S., Hara S., Kurosawa H., Takanashi Y. [A case of endocardial cushion defect without interatrial communication]. Nihon Kyobu Geka Gakkai Zasshi. 1986 Nov;34(11):2017–2020. [PubMed] [Google Scholar]
  8. Silverman N. H., Ho S. Y., Anderson R. H., Smith A., Wilkinson J. L. Atrioventricular septal defect with intact atrial and ventricular septal structures. Int J Cardiol. 1984 May;5(5):567–573. doi: 10.1016/0167-5273(84)90167-0. [DOI] [PubMed] [Google Scholar]
  9. Tenckhoff L., Stamm S. J. An analysis of 35 cases of the complete form of persistent common atrioventricular canal. Circulation. 1973 Aug;48(2):416–427. doi: 10.1161/01.cir.48.2.416. [DOI] [PubMed] [Google Scholar]
  10. Thiene G., Wenink A. C., Frescura C., Wilkinson J. L., Gallucci V., Ho S. Y., Mazzucco A., Anderson R. H. Surgical anatomy and pathology of the conduction tissues in atrioventricular defects. J Thorac Cardiovasc Surg. 1981 Dec;82(6):928–937. [PubMed] [Google Scholar]
  11. VAN MIEROP L. H., ALLEY R. D., KAUSEL H. W., STRANAHAN A. The anatomy and embryology of endocardial cushion defects. J Thorac Cardiovasc Surg. 1962 Jan;43:71–83. [PubMed] [Google Scholar]

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