[Echocardiographic evaluation of a single atrioventricular valve: problem of differential diagnosis].
In the normal subject, the echocardiographic crux-cordis is defined by the spatial relationship between the plane of the interatrial and interventricular septa and the plane of the A-V valves. The bidimensional echocardiographic image of the crux-cordis may be obtained from various approaches: apical, subcostal, or precordial. In the present study we have assessed the usefulness of 2-D echocardiographic analysis of the crux-cordis in identifying the presence of a common A-V valve vs a single A-V valve (i.e. with atresia of the contralateral valve) in univentricular hearts (UH). We have studied 55 patients. Eight patients had a UH with a common A-V valve (6 with a rudimentary chamber, and 2 without a rudimentary chamber). Thirty-three patients were found to have atresia of the right A-V valve (29 with absent connection, and 4 with an imperforated valve), and 14 with atresia of the left A-V valve (9 with absent connection, and 5 with an imperforate valve). A correct differential diagnosis between common A-V valve and atresia of an A-V valve was achieved in 53 out of 55 patients through the direct visualization of the atretic atrial floor and by recognizing the origin of the leaflets of the one patent valve present. Of the patients with UH and common A-V valve, 5 presented a low interatrial septal defect, 3 a single atrium, 3 an interventricular septum which was clearly misaligned with the echocardiographic crux-cordis, in 5 an analysis of the crux-cordis did not permit visualization of a ventricular septal structure of which 3 resulted as false negatives.(ABSTRACT TRUNCATED AT 250 WORDS)
D003937:Diagnosis, Differential; D004452:Echocardiography; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006351:Heart Valves / Q000002:abnormalities*; D006801:Humans
Valutazione ecocardiografica di una sola valvola atrioventricolare: problemi di diagnostica differenziale.