Cross-sectional echocardiographic assessment of atrioventricular septal defect: Basic morphology and preoperative risk factors

Accurate evaluation of an atrioventricular septal defect is readily achieve d by echocardiography. A sound understanding of the basic morphology and as sociated lesions is key to this approach. This article first details the fe atures that are common to all hearts with an atrioventricular septal defect , irrespective of the presence or absence of an interatrial or interventric ular communication. These common features are: (1) inlet outlet disproporti on; (2) absence of the atrioventricular muscular septum; (3) abnormal posit ion of the left ventricular papillary muscles; (4) abnormal configuration o f the atrioventricular valves and, (5) cleft in the left atrioventricular v alve. These are all predicated by a sprung atrioventricular junction. Secon d, is a detailed outline of the associated risk factors that must be identi fied by the echocardiographer prior to presenting the patient for surgical management, with the most important ones being abnormalities of the left at rioventricular valve and left ventricular outflow tract obstruction. Indeed , in this current era it is rarely necessary to perform other investigation s prior to surgical repair.