The angle of the components of the common atrioventricular valve predicts the outcome of surgical correction in patients with atrioventricular septal defect and common atrioventricular junction.
BACKGROUND
Three-dimensional echocardiography offers new insights into valvar function in atrioventricular septal defects (AVSDs). The aim of this study was to identify a morphological marker to predict the functional outcomes of left atrioventricular valves (AVVs) following the repair of AVSDs.


METHODS
Twenty-nine consecutive patients were evaluated preoperatively using 2-dimensional and 3-dimensional echocardiography. The angle of the AVV relative to the crux of the heart was measured in multiplanar review mode.


RESULTS
The severity of postoperative left AVV regurgitation was correlated with preoperative valvar angle, being more acute in patients with moderate or severe regurgitation (mean, 57 +/- 13 degrees vs 83 +/- 9 degrees in patients with no or mild regurgitation; P = .002). Angles < or = 59 degrees predicted severe regurgitation with 79% specificity.


CONCLUSIONS
Multiplanar review of 3-dimensional data sets is valuable for the assessment of the functional morphology of AVSD valves. Using this technique, more acute AVV angles predicted increased likelihood of severe regurgitation following surgical repair.
Bharucha
Tara
T
Congenital Cardiac Centre, Southampton University Hospitals NHS Trust, Southampton, United Kingdom.
Sivaprakasam
Muthukumaran C
MC
Haw
Marcus P
MP
Anderson
Robert H
RH
Vettukattil
Joseph J
JJ
D001283:Atrioventricular Node / Q000000981:diagnostic imaging*; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging* / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging* / Q000601:surgery*; D006351:Heart Valves / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome