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. 1981 Sep;46(3):254–262. doi: 10.1136/hrt.46.3.254

Detection and assessment of straddling and overriding atrioventricular valves by two dimensional echocardiography.

J F Smallhorn, G Tommasini, F J Macartney
PMCID: PMC482642  PMID: 7295418

Abstract

Sixteen patients with a straddling tricuspid and two with a straddling mitral valve were identified by two dimensional echocardiography. In all but one the atrioventricular valves appeared at the same level, indicating absence of the ventriculoatrial septum. A straddling valve was diagnosed by identifying subvalvular apparatus from one atrioventricular valve in both chambers, independent of whether they were ventricles or rudimentary chambers. Further confirmation was obtained during real time study where the valve leaflets appeared to fly through the ventricular septal defect. Overriding of the valve annulus was greater than 50% in 12 and less than 50% in five, with one other patient having none detectable. The relation of the central fibrous body to the tip of the interventricular septum was reliable in assessing overriding of greater than 50%, but where it was less than 50% other views were necessary to detect its presence. The diagnosis of straddling with or without overriding of an atrioventricular valve can be reliably made by two dimensional echocardiography, and carries important implications relating to the type of surgical intervention possible, and in those with a straddling tricuspid valve, the position of the atrioventricular node.

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Selected References

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

  1. Anderson R. H., Becker A. E., Arnold R., Wilkinson J. L. The conducting tissues in congenitally corrected transposition. Circulation. 1974 Nov;50(5):911–923. doi: 10.1161/01.cir.50.5.911. [DOI] [PubMed] [Google Scholar]
  2. Aziz K. U., Paul M. H., Muster A. J., Idriss F. S. Positional abnormalities of atrioventricular valves in transposition of the great arteries including double outlet right ventricle, atrioventricular valve straddling and malattachment. Am J Cardiol. 1979 Nov;44(6):1135–1145. doi: 10.1016/0002-9149(79)90179-6. [DOI] [PubMed] [Google Scholar]
  3. Bharati S., McAllister H. A., Jr, Lev M. Straddling and displaced atrioventricular orifices and valves. Circulation. 1979 Sep;60(3):673–684. doi: 10.1161/01.cir.60.3.673. [DOI] [PubMed] [Google Scholar]
  4. LaCorte M. A., Fellows K. E., Williams R. G. Overriding tricuspid valve: echocardiographic and angiocardiographic features. Am J Cardiol. 1976 May;37(6):911–919. doi: 10.1016/0002-9149(76)90118-1. [DOI] [PubMed] [Google Scholar]
  5. 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]
  6. Milo S., Ho S. Y., Macartney F. J., Wilkinson J. L., Becker A. E., Wenink A. C., Gittenberger de Groot A. C., Anderson R. H. Straddling and overriding atrioventricular valves: morphology and classification. Am J Cardiol. 1979 Nov;44(6):1122–1134. doi: 10.1016/0002-9149(79)90178-4. [DOI] [PubMed] [Google Scholar]
  7. Mortera C., Hunter S., Terry G., Tynan M. Echocardiography of primitive ventricle. Br Heart J. 1977 Aug;39(8):847–855. doi: 10.1136/hrt.39.8.847. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Pacifico A. D., Soto B., Bargeron L. M., Jr Surgical treatment of straddling tricuspid valves. Circulation. 1979 Sep;60(3):655–664. doi: 10.1161/01.cir.60.3.655. [DOI] [PubMed] [Google Scholar]
  9. Rastelli G. C., Ongley P. A., Titus J. L. Ventricular septal defect of atrioventricular canal type with straddling right atrioventricular valve and mitral valve deformity. Circulation. 1968 May;37(5):816–825. doi: 10.1161/01.cir.37.5.816. [DOI] [PubMed] [Google Scholar]
  10. Seward J. B., Tajik A. J., Ritter D. G. Echocardiographic features of straddling tricuspid valve. Mayo Clin Proc. 1975 Aug;50(8):427–434. [PubMed] [Google Scholar]
  11. Tabry I. F., McGoon D. C., Danielson G. K., Wallace R. B., Tajik A. J., Seward J. B. Surgical management of straddling atrioventricular valve. J Thorac Cardiovasc Surg. 1979 Feb;77(2):191–201. [PubMed] [Google Scholar]
  12. Tajik A. J., Seward J. B., Hagler D. J., Mair D. D., Lie J. T. Two-dimensional real-time ultrasonic imaging of the heart and great vessels. Technique, image orientation, structure identification, and validation. Mayo Clin Proc. 1978 May;53(5):271–303. [PubMed] [Google Scholar]
  13. Tynan M. J., Becker A. E., Macartney F. J., Jiménez M. Q., Shinebourne E. A., Anderson R. H. Nomenclature and classification of congenital heart disease. Br Heart J. 1979 May;41(5):544–553. doi: 10.1136/hrt.41.5.544. [DOI] [PMC free article] [PubMed] [Google Scholar]

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