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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*
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.

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.

Type
Original Manuscripts
Copyright
Copyright © Cambridge University Press 1995

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