Skip to main content
PMC home page
British Heart Journal logoLink to British Heart Journal
. 1979 Dec;42(6):640–656. doi: 10.1136/hrt.42.6.640

Angiocardiographic appearances of atrioventricular defects with particular reference to distinction of ostium primum atrial septal defect from common atrioventricular orifice.

F J Macartney, P G Rees, K Daly, G P Piccoli, J F Taylor, M R De Leval, J Stark, R H Anderson
PMCID: PMC482217  PMID: 534581

Abstract

Preoperative distinction between common atrioventricular orifice and ostium primum atrial septal defect may be difficult. To improve diagnostic accuracy, the right and left ventricle angiocardiograms were reviewed 'blind' in 92 patients with atrioventricular defects. The true diagnosis was known from necropsy or surgery in 60. Angiocardiograms had been obtained in various projections with or without craniocaudal tilt. Those features thought to distinguish between common orifice and ostium primum were coded, together with the ventricular systolic pressures. Computerised disciminant function analysis identified the following distinguishing features: (1) right ventricular systolic pressure; (2) immediate right ventricular outflow tract opacification from the left ventricle; (3) identification of the anterior attachment of the mitral component; (4) recognition of a single straddling atrioventricular orifice; (5) passage of contrast medium above or below the anterior or posterior bridging leaflets. Feature (3) indicates that in contrast to classic teaching the direct septal attachment of the mitral component does not contribute to the 'gooseneck' in complete atrioventricular defects. The significance of (4) and (5) is that they may be identified from right as well as left ventriculography, and are more likely to be identified in oblique than standard projections. Computerisation produced a correct diagnosis in 92 per cent of known cases, and determined precise probabilities of diagnosis in the remainder.

Full text

PDF
640

Images in this article

643Image
on p.643
644Image
on p.644
645Image
on p.645
647Image
on p.647
648Image
on p.648
650Image
on p.650

Selected References

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

  1. BARON M. G., WOLF B. S., STEINFELD L., VANMIEROP L. H. ENDOCARDIAL CUSHION DEFECTS. SPECIFIC DIAGNOSIS BY ANGIOCARDIOGRAPHY. Am J Cardiol. 1964 Feb;13:162–175. doi: 10.1016/0002-9149(64)90171-7. [DOI] [PubMed] [Google Scholar]
  2. Bargeron L. M., Jr, Elliott L. P., Soto B., Bream P. R., Curry G. C. Axial cineangiography in congenital heart disease. Section I. Concept, technical and anatomic considerations. Circulation. 1977 Dec;56(6):1075–1083. doi: 10.1161/01.cir.56.6.1075. [DOI] [PubMed] [Google Scholar]
  3. Bharati S., Lev M. The spectrum of common atrioventricular orifice (canal). Am Heart J. 1973 Oct;86(4):553–561. doi: 10.1016/0002-8703(73)90148-8. [DOI] [PubMed] [Google Scholar]
  4. Blieden L. C., Randall P. A., Castaneda A. R., Lucas R. V., Jr, Edwards J. E. The "goose neck" of the endocardial cushion defect: anatomic basis. Chest. 1974 Jan;65(1):13–17. doi: 10.1378/chest.65.1.13. [DOI] [PubMed] [Google Scholar]
  5. Brandt P. W., Clarkson P. M., Neutze J. M., Barratt-Boyes B. G. Left ventricular cineangiocardiography in endocardial cushion defect (persistent common atrioventricular canal). Australas Radiol. 1972 Dec;16(4):367–376. doi: 10.1111/j.1440-1673.1972.tb01383.x. [DOI] [PubMed] [Google Scholar]
  6. Ebert P. A., Goor D. A. Complete atrioventricular canal malformation: further clarification of the anatomy of the common leaflet and its relationship to the VSD in surgical correction. Ann Thorac Surg. 1978 Feb;25(2):134–143. doi: 10.1016/s0003-4975(10)63506-0. [DOI] [PubMed] [Google Scholar]
  7. Elliott L. P., Bargeron L. M., Jr, Bream P. R., Soto B., Curry G. C. Axial cineangiography in congenital heart disease. Section II. Specific lesions. Circulation. 1977 Dec;56(6):1048–1093. doi: 10.1161/01.cir.56.6.1048. [DOI] [PubMed] [Google Scholar]
  8. Girod D., Raghib G., Wang Y., Adams P., Jr, Amplatz K. Angiocardiographic characteristics of persistent common atrioventricular canal. Radiology. 1965 Sep;85(3):442–447. doi: 10.1148/85.3.442. [DOI] [PubMed] [Google Scholar]
  9. Gotsman M. S., Beck W., Schrire V. Left ventricular cine-angiocardiography in endocardial cushion defect. Br Heart J. 1968 Mar;30(2):182–187. doi: 10.1136/hrt.30.2.182. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Liberthson R. R., Paul M. H., Muster A. J., Arcilla R. A., Eckner F. A., Lev M. Straddling and displaced atrioventricular orifices and valves with primitive ventricles. Circulation. 1971 Feb;43(2):213–226. doi: 10.1161/01.cir.43.2.213. [DOI] [PubMed] [Google Scholar]
  11. Macartney F. J., Bain H. H., Ionescu M. I., Deverall P. B., Scott O. Angiocardiographic/pathologic correlations in congenital mitral valve anomalies. Eur J Cardiol. 1976 Jun;4(2):191–211. [PubMed] [Google Scholar]
  12. Piccoli G. P., Gerlis L. M., Wilkinson J. L., Lozsadi K., Macartney F. J., Anderson R. H. Morphology and classification of atrioventricular defects. Br Heart J. 1979 Dec;42(6):621–632. doi: 10.1136/hrt.42.6.621. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Piccoli G. P., Wilkinson J. L., Macartney F. J., Gerlis L. M., Anderson R. H. Morphology and classification of complete atrioventricular defects. Br Heart J. 1979 Dec;42(6):633–639. doi: 10.1136/hrt.42.6.633. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Rastelli G., Kirklin J. W., Kincaid O. W. Angiocardiography of persistent common atrioventricular canal. Mayo Clin Proc. 1967 Apr;42(4):200–209. [PubMed] [Google Scholar]
  15. Rastelli G., Kirklin J. W., Titus J. L. Anatomic observations on complete form of persistent common atrioventricular canal with special reference to atrioventricular valves. Mayo Clin Proc. 1966 May;41(5):296–308. [PubMed] [Google Scholar]
  16. Somerville J., Jefferson K. Left ventricular angiocardiography in atrioventricular defects. Br Heart J. 1968 Jul;30(4):446–457. doi: 10.1136/hrt.30.4.446. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Sridaromont S., Feldt R. H., Ritter D. G., Davis G. D., McGoon D. C., Edwards J. E. Double-outlet right ventricle associated with persistent common atriventricular canal. Circulation. 1975 Nov;52(5):933–942. doi: 10.1161/01.cir.52.5.933. [DOI] [PubMed] [Google Scholar]
  18. 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]
  19. WAKAI C. S., EDWARDS J. E. Pathologic study of persistent common atrioventricular canal. Am Heart J. 1958 Nov;56(5):779–794. doi: 10.1016/0002-8703(58)90221-7. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES