Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-24T10:48:21.988Z Has data issue: false hasContentIssue false
  • English
  • Français

The degree of scooping of the interventricular septum influences electrocardiographic findings in atrioventricular septal defect

Published online by Cambridge University Press:  19 August 2008

Kiyoshi Suzuki ,
Shigekazu Mimori ,
Yasuo Murakami ,
Katsuhiko Mori ,
Katsuhiko Tatsuno ,
Toshio Kikuchi ,
Yukihiro Takahashi  and
Eiji Ohtaki
Kiyoshi Suzuki*
Affiliation:
From the Department of Pediatric Cardiology, Sakakibara Heart Institute, Tokyo
Shigekazu Mimori
Affiliation:
From the Department of Pediatric Cardiology, Sakakibara Heart Institute, Tokyo
Yasuo Murakami
Affiliation:
From the Department of Pediatric Cardiology, Sakakibara Heart Institute, Tokyo
Katsuhiko Mori
Affiliation:
From the Department of Pediatric Cardiology, Sakakibara Heart Institute, Tokyo
Katsuhiko Tatsuno
Affiliation:
Department of Cardiac Surgery, Sakakibara Heart Institute, Tokyo
Toshio Kikuchi
Affiliation:
Department of Cardiac Surgery, Sakakibara Heart Institute, Tokyo
Yukihiro Takahashi
Affiliation:
Department of Cardiac Surgery, Sakakibara Heart Institute, Tokyo
Eiji Ohtaki
Affiliation:
Department of Cardiology, Sakakibara Heart Institute, Tokyo
*
Dr. Kiyoshi Suzuki, Department of Pediacric Cardiology, Sakakibara Heart Institute, 2-5-4 Yoyogi, Shibuya-ku, Tokyo 151, Japan. Tel. 81-3-3375-3111; Fax. 81-3-3375-9218.
Get access Rights & Permissions [Opens in a new window]

Abstract

The aim of this study was to clarify those morphological features and hemodynamic stress factors which influence the electrocardiographic findings in atrioventricular septal defect. In 64 patients with the incomplete form of atrioventricular septal defect (separate valvar orifices) with usual atrial arrangement, the length from the left ventricular apex to the aortic valve (outlet dimension), to the so-called cleft (scoop dimension), and to the lowest point of the left atrioventricular valve (inlet dimension) were measured by biplanar cineangiography. The size of the ostium primum defect, the ventricular pressure ratio, and the pulmonary/systemic flow ratio were also evaluated. The results showed that the lower the scoop/outlet ratio (r=0.60, p<0.001), or the higher the ventricular pressure ratio (r= −0.55, p<0.001), the more deviated to the left and superior was the mean frontal QRS axis. These factors also had significant correlation with the QRS patterns in the Frank vectorcardiogram. We conclude that the scoop/outlet ratio, supposedly reflecting the degree of scooping of the interventricular septum, is one of the most significant factors which influence the electrocardiographic findings in atrioventricular septal defect.

Keywords

Atrioventricular septal defectelectrocardiogramdegree of scooping of the interventricular septumconduction system
Type
Original Manuscripts
Information
Cardiology in the Young , Volume 5 , Issue 3 , July 1995 , pp. 262 - 266
Copyright
Copyright © Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Suzuki, K, Murakami, Y, Tatsuno, K, Takahashi, Y, Kikuchi, T, Mori, K, Mimori, S. Atypical form of atrioventricular septal defect without left axis deviation: relation between morphology and unusual QRS axis. Br Heart J 1993; 70: 180–184.CrossRefGoogle ScholarPubMed
2.Feldt, RH, DuShane, JW, Titus, JL. The atrioventricular conduction system in persistent common atrioventricular canal defect: correlations with electrocardiogram. Circulation 1970; 42: 437–444.CrossRefGoogle ScholarPubMed
3.Thiene, G, Wenink, ACG, Frescura, C, Wilkinson, JL, Gallucci, V, Ho, SY, Mazzucco, A, Anderson, RH. Surgical anatomy and pathology of the conduction tissues in atrioventricular defects. J Thorac Cardiovasc Surg 1981; 82: 928–937.CrossRefGoogle ScholarPubMed
4.Anderson, RH, Baker, EJ, Ho, SY, Rigby, ML, Ebels, T. The morphology and diagnosis of atrioventricular septal defects. Cardiol Young 1991; 1: 290–305.CrossRefGoogle Scholar
5.Tenckhoff, L, Stamm, SJ. An analysis of 35 cases of the complete form of persistent common atrioventricular canal. Circulation 1973; 48: 416–427.CrossRefGoogle ScholarPubMed
6.Ongley, PA, Pongpanich, B, Spangler, JG, Feldt, RH. The electrocardiogram in atrioventricular canal. In: Feldt, RH (ed). Atrioventricular Canal Defects. WB Saunders, Philadelphia, 1976, pp 51–75.Google Scholar
7.Piccoli, GP, Gerlis, LM, Wilkinson, JL, Lozsadi, K, Macartney, FJ, Anderson, RH. Morphology and classification of atrioventricular defects. Br Heart J 1979; 42: 621–632.CrossRefGoogle ScholarPubMed
8.Ebels, T, Anderson, RH, Devine, WA, Debich, DE, Penkoske, PA, Zuberbuhler, JR. Anomalies of the left atrioventricular valve and related ventricular septal morphology in atrioventricular septal defects. J Thorac Cardiovasc Surg 1990; 99: 299–307.CrossRefGoogle ScholarPubMed
9.Macagrtney, FJ, Rees, PG, Daly, K, Piccoli, GP, Taylor, JFN, De Leval, MR, Stark, J, Anderson, RH. Angiocardiographic appearances of atrioventricular defects with particular reference to distinction of ostium primum atrial septal defect from common atrioventricular orifice. Br Heart J 1979; 42: 640–656.CrossRefGoogle Scholar
10.Towbin, R, Schwartz, D. Endocardial cushion defects: embryology, anatomy, and angiography. Am J Roentgenol 1981; 136: 157–162.CrossRefGoogle ScholarPubMed
11.Amplatz, K, Moller, JH. Radiology of Congenital Heart Disease. Mosby Year Book, St. Louis, 1993, pp 365–393.Google Scholar
12.Wenink, ACG, Zevallos, JC. Developmental aspects of atrioventricular septal defects. Int J Cardiol 1988; 18: 65–78.CrossRefGoogle ScholarPubMed
13.Penkoske, PA, Neches, WH, Anderson, RH, Zuberbuhler, JR. Further observations on the morphology of atrioventricular septal defects. J Thorac Cardiovasc Surg 1985; 90: 611–622.CrossRefGoogle ScholarPubMed
14.Gutgesell, HP, Huhta, JC. Cardiac septation in atrioventricular canal defect. J Am Coll Cardiol 1986; 8: 1421–1424.CrossRefGoogle ScholarPubMed
15.Ho, SY, Gerlis, LM, Toms, J, Lincoln, C, Anderson, RH. Morphology of the posterior junctional area in atrioventricular septal defects. Ann Thorac Surg 1992; 54: 264–270.CrossRefGoogle ScholarPubMed