Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-19T13:36:22.514Z Has data issue: false hasContentIssue false
  • English
  • Français

Anatomy and echocardiography of discordant atrioventricular connections

Published online by Cambridge University Press:  13 October 2006

William T. Mahle ,
Gerald R. Marx  and
Robert H. Anderson
William T. Mahle
Affiliation:
Children's Healthcare of Atlanta and the Emory University School of Medicine, Atlanta, Georgia, United States of America
Gerald R. Marx
Affiliation:
Children's Hospital, Harvard University School of Medicine, Boston, Massachusetts, United States of America
Robert H. Anderson
Affiliation:
Cardiac Unit, University College London Institute of Child Health, London, United Kingdom
Get access Rights & Permissions [Opens in a new window]

Abstract

The most appropriate way of describing the congenital cardiac malformations unified because the atrial chambers are joined across the atrioventricular junctions to morphologically inappropriate ventricles has long been contentious. In the past, the lesions have been described in such arcane terms as mixed levocardia,1 while “ventricular inversion” still retains it currency in some circles. As we will show in this review, the abnormal arrangements at the atrioventricular junctions can be found with various patterns, but most frequently the patients also have the arterial trunks arising from morphologically inappropriate ventricles. This combination is best described as congenitally corrected transposition, and will form the focus of our review. It is salutary to note that, when von Rokitansky gave the first description of this combination,2 one of his illustrations was ideally suited to aid the understanding of modern-day echocardiographers (Fig. 1). We hope to emulate von Rokitansky in our own review.

Keywords

Congenitally corrected transpositionl-transpositionventricular inversion
Type
Discordant Atrioventricular Connections
Information
Cardiology in the Young , Volume 16 , Supplement S3: Controversies and Challenges of the Atrioventricular Junctions and Other Challenges Facing Paediatric Cardiovascular Practitioners and their Patients , September 2006 , pp. 65 - 71
Copyright
© 2006 Cambridge University Press

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

Lev M, Rowlatt UF. Pathological anatomy of mixed levocardia. A review of thirteen cases of atrial or ventricular inversion with or without corrected transposition. Am J Cardiol 1961; 8: 216–263.Google Scholar
von Rokitansky CF. Die Defecte der Scheidewande des Herzens. Vienna: Pathologisch-Anatomisch Wilhelm Braumuller, 1875.
Anderson RH, Becker AE, Freedom RM, et al. Sequential segmental analysis of congenital heart disease. Pediatr Cardiol 1984; 5: 281–288.Google Scholar
Van Praagh R. The segmental approach to diagnosis in congenital heart disease. In: Bergsma D (ed.). Birth Defects. Original Article Series, Vol VIII, No. 5. The Fourth Conference on The Clinical Delineation of Birth Defects. Part XV. The Cardiovascular System. The National Foundation-March of Dimes. Williams and Wilkins Company, Baltimore, 1972, pp 4–26.
Tynan MJ, Becker AE, Macartney FJ, Quero-Jimenez M, Shinebourne EA, Anderson RH. Nomenclature and classification of congenital heart disease. Br Heart J 1979; 41: 544–553.Google Scholar
Van Praagh R, Van Praagh S, Vlad P, Keith JD. Anatomic types of congenital dextrocardia. Diagnostic and embryologic implications. Am J Cardiol 1964; 13: 510–531.Google Scholar
Van Praagh R. Nomenclature and classification: Morphologic and segmental approach to diagnosis. In: Moller JH, Hoffman JIE (eds). Pediatric Cardiovascular Medicine. Churchill Livingstone, New York, 2000, pp 275–288.
Anderson RH. Nomenclature and classification: sequential segmental analysis. In: Moller JH, Hoffman JIE (eds). Pediatric Cardiovascular Medicine. Churchill Livingstone, New York, 2000, pp 263–274.
Van Praagh R. What is congenitally corrected transposition? New Engl J Med 1970; 282: 1097–1098.Google Scholar
Allwork SP, Bentall HH, Becker AE, et al. Congenitally corrected transposition of the great arteries: morphologic study of 32 cases. Am J Cardiol 1976; 38: 910–923.Google Scholar
Anderson RH, Becker AE, Arnold R, Wilkinson JL. The conducting tissues in congenitally corrected transposition. Circulation 1974; 50: 911–923.Google Scholar
Hosseinpour AR, Anderson RH, Ho SY. The anatomy of the septal perforating arteries in normal and congenitally malformed hearts. J Thorac Cardiovasc Surg 2001; 121: 1046–1052.Google Scholar
Prieto LR, Hordof AJ, Secic M, Rosenbaum MS, Gersony WM. Progressive tricuspid valve disease in patients with congenitally corrected transposition of the great arteries. Circulation 1998; 98: 997–1005.Google Scholar
Devaney EJ, Charpie JR, Ohye RG, Bove EL. Combined arterial switch and Senning operation for congenitally corrected transposition of the great arteries: patient selection and intermediate results. J Thorac Cardiovasc Surg 2003; 125: 500–507.Google Scholar