Left ventricular outflow tract obstruction in atrioventricular septal defects: A pathologic and morphometric evaluation

P. Gallo, R. Formigari, N. J. Hokayem, F. D'Offizi, C. D'Alessandro, P. Francalanci, G. D'Amati, V. Colloridi, F. Pizzuto

Research output: Contribution to journalArticlepeer-review

Abstract

Subaortic stenosis has been described with increasing frequency as an ominous feature of atrioventricular septal defect (AVSD), especially following surgical correction of the anomaly in non-Down's syndrome patients. In order to study the surgical anatomy of the left ventricular outflow tract in this malformation, 48 hearts featuring AVSD were examined. Obstructive lesions were classified into unequivocal forms (class A, 13.5%) and potential ones (class B, 10.8%). In the remaining hearts (class C, 75.7%) no obstruction was noted. In class A, subaortic stenosis was due to exaggeration of the anticipated anomalous arrangement of atrioventricular valve tensor apparatus, to the persistence of a subaortic muscular infundibulum, and to a discrete fibrous diaphragm. A potential for subaortic stenosis is provided by the unwedged position of the aortic valve. The left ventricular outflow tract is transformed into a long, forward-displaced fibromuscular channel. Morphometric analysis showed in AVSD (with both common annulus and separate orifices) a significantly (p

Original languageEnglish
Pages (from-to)513-521
Number of pages9
JournalClinical Cardiology
Volume14
Issue number6
Publication statusPublished - 1991

Keywords

  • atrioventricular septal defect
  • atrioventricular valves pathology
  • cardiac surgery
  • morphometry
  • subaortic stenosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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