Correlation of morphology of the left ventricular outflow tract with two-dimensional Doppler echocardiography and magnetic resonance imaging in atrioventricular septal defect

• Published in: The American journal of cardiology Vol. 63; no. 15; pp. 1137 - 1140
• Main Authors: Wenink, Arnold C.G., Ottenkamp, Jaap, Guit, Gerard L., Draulans-Noe, H.A.Yvonne, Doornbos, Joost
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-05-1989; Elsevier
• Subjects: Biological and medical sciences; Blood Flow Velocity; Cardiology. Vascular system; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava; Echocardiography, Doppler; Heart; Heart Septal Defects, Atrial - complications; Heart Septal Defects, Atrial - pathology; Heart Septal Defects, Atrial - physiopathology; Heart Septal Defects, Ventricular - complications; Heart Septal Defects, Ventricular - pathology; Heart Septal Defects, Ventricular - physiopathology; Humans; Magnetic Resonance Imaging; Medical sciences; Human; Doppler ultrasound study; Endocardial Cushion defect; Echocardiography; Congenital; Ultrasonic investigation; Cardiovascular disease; Nuclear magnetic resonance imaging; Left ventricle; Heart disease; Child; Aortic valve; Two dimensional technique
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(89)90095-7

In atrioventricular (AV) septal defect, the architecture of the left ventricular (LV) outflow tract differs consistently from the normal tract. In patients with separate AV valves and in those with a common valve with septal attachment of the superior bridging leaflet (Rastelli type A), the LV outflow tract below the anteriorly positioned aorta is long and narrow. Possible obstruction of this outflow tract has been attributed to abnormal papillary muscles
1,2 and to an “atrial fold” that is the anterior wall of the left atrium reinforcing the aortic-left AV fibrous continuity.
3 Less known is the anterolateral muscle bundle,
4 often very prominent in AV septal defect.
5 This muscle bundle that replaces the left coronary-AV fibrous continuity could well contribute to a possible stenosis of the LV outflow tract. We carried out Doppler echocardiography and magnetic resonance imaging studies to evaluate the role of the anterolateral muscle bundle in the possible systolic narrowing of the subaortic outflow tract.