medigraphic.com

2008, Number 1

<< Back Next >>

Arch Cardiol Mex 2008; 78 (1)

Atrioventricular septal defect. Anatomopathologic study and embryological correlation

Kuri NM, Martínez ME, Muñoz CL, Espínola ZN

Language: Spanish
References: 30
Page: 19-29
PDF size: 758.68 Kb.


ABSTRACT

Atrioventricular septal defect is a complex congenital heart disease in which cardiac septation is deficient especially at atrioventricular and ventricular levels. The anatomopathologic experience at the National Institute of Cardiology “Ignacio Chávez” is described; an anatomo-embryological correlation was made to gain an insight of the pathogenesis. Seventy hearts were analyzed morphologically with the sequential segmentary system. Atrial situs, connections of cardiac segments, cardiac septa, septal defects, ventricular geometry, fibrous skeleton and associated anomalies were determined. Histologic sections of chick embryonic hearts were analyzed and compared with stages of human heart development, serving as basis to elaborate the anatomo- embryological correlation. Seventy hearts had a common atrioventricular valve and five had two separated atrioventricular valves. The ventricular septal defect was open in the first type and closed in the second; the other features were the same in both. This cardiopathy is shown as a broad spectrum of anatomical variations. The morphological knowledge of this cardiac malformation is useful to understand the physiopathology, to make a precise clinical diagnosis, and to give the best orientation to the surgeon. Delay in the development of the atrioventricular cushions is emphasized as the pathogenetic explanation for this type of congenital heart disease.


REFERENCES

  1. Van Mierop LHS, Alley RD, Kausel HW, Stranahan A: The anatomy and embryology of endocardial cushion defects. J Thorac Cardiovasc Surg 1962; 43: 71-83.

  2. Becker AE, Anderson RH: Pathology of congenital heart disease. London. Butterworths, 1981, pp. 77-92.

  3. 3. Wakai SC, Edwards JE: Pathologic study of persistent common atrioventricular canal. Mayo Clinic Proc 1958; 56: 779-794.

  4. Piero GP, Leon MG, Wilkinson JG, Lozsadi K, Macartney FJ, Anderson RH: Morphology and classification of atrioventricular defects. Am Heart J 1979; 42: 621-632.

  5. Edwards JE: Congenital malformations of the heart and great vessels. In Pathology of the heart. Gould S. E. (ed). Springfield. Thomas, 1960, pp. 263-268.

  6. Penkoske PA, Neches WH, Anderson RH, Zuberbuhler JR: Further observations on the morphology of atrioventricular septal defects. J Thorac Cardiovasc Surg 1985; 90: 611-622.

  7. Falcao S, Daliento L, Ho SY, Rigby ML, Anderson RH: Cross sectional echocardiography assessment of the extent of the atrial septum relative to atrioventricular connection in atrioventricular septal defect. Heart 1999; 81: 199-205.

  8. Silverman NH, Ho SY, Anderson RH, Smith A, Wilkinson L: Atrioventricular septal defect with intact atrial and ventricular septal structures. Int J Cardiol 1984; 5: 567-572.

  9. Mahle WT, Shirali GS, Anderson RH: Echo-morphological correlates in patients with atrioventricular septal defect and common atrioventricular junction. Cardiol Young 2006; 16: 43-51.

  10. Ellis RW, Van Creveld SA: Syndrome characterized by ectodermal dysplasia, polydactyly, chondro-dysplasia and congenital morbus cordis. Report of three cases. Arch Dis Child 1940; 15: 65-84.

  11. Gustavson KH, Kreuger A, Petersson PO: Syndrome characterized by lingual malformation, polydactyly, tachypnea and psychomotor retardation (Mohr syndrome). Clin Genet 1971; 2: 261: 47-48.

  12. Salmon MA: Developmental Defects and Syndromes. Aylesbury HM + M Publishers. 1978, pp. 346-356.

  13. Calderón CJ, Flores A, Ramírez S, Patiño BE, Zabal C, García MJ, et al: Resultados en la correlación quirúrgica de la cardiopatía congénita en el síndrome de Down. Arch Cardio Mex 2003; 74: 39-44.

  14. Tynan MJ, Becker AE, Macartney FJ, Quero-Jiménez M, Shinebourne EA, Anderson RH: Nomenclature and classification of congenital heart disease. Br Heart J 1979; 41: 544-553.

  15. Gongora DG, Attie F, Quero-Jiménez M, Muñoz Castellanos L, Anderson RH, Tynan M, et al: La secuencia diagnóstica de las cardiopatías congénitas. Arch Inst Cardiol Mex 1982; 52: 69-78.

  16. Rastelli GC, Kirklin WJ, Titus LJ: Anatomic observations on complete form of persistent common atrioventricular canal with special reference to atrioventricular valve. Mayo Clin Proc 1966; 41: 296-308.

  17. Hamburger V, Hamilton HL: A series of normal stages in the development of the chick embryo. J Morphol 1951; 88: 49-92.

  18. De la Cruz MV, Muñoz Armas S, Muñoz Castellanos L: Development of the chick heart. Baltimore and London. The Johns Hopkins University Press. 1972, pp. 31-63.

  19. Streeter GL: Developmental Horizons in human embryos. Description of age group XIII, embryos about 4 or 5 millimeters long, and age group XIV, period of Indentation of the lens vesicles. Carnegie Inst Wash Contribs to Ebryol 1945; 31: 27-63.

  20. Streeter GL: Developmental horizons in human embryos. Description of age groups XV, XVI, XVII, XVIII, being the third issue of a survey of the Carnegie collection. Carnegie Inst Wash Publ. 575 Contribs to embryol 1948; 32: 123-203.

  21. Goor DA, Lillehei CW: Congenital malformations of the heart. New York Grune and Stratton Inc, 1971, pp. 38-102.

  22. Allwork SP, Anderson RH: Developmental anatomy of the membranous part of the ventricular septum in the human heart. Br Heart J 1979; 41: 275-280.

  23. Anderson RH, Zuberbuhler JR, Penkoske PA, Neches WH: Of clefts commisures and things. J Thorac Cardiovasc Surg 1985; 90: 605-610.

  24. Ebels T, Ho SY, Anderson RH, Meijboom EJ, Eigelaar A: The surgical anatomy of the left outflow tract in atrioventricular septal defect. Ann Thorac Surg 1986; 41: 483-488.

  25. Brandt PWT, Clarkson PM, Neutze JM, Barratt-Boyesbg: Left ventricular cineangiography in endocardial cushion defect (persistent common atrioventricular canal. Australasian Radiology 1972; 16: 367-376.

  26. Becker AE, Anderson RH: Atrioventricular septal defects: What’s in a name? Thorac Cardiovasc Surg 1982; 83: 461-469.

  27. Feldt RH, Dushane JW, Titus JL: The atrioventricular conduction system in persistent common atrioventricular canal defect: correlations with electrocardiogram. Circulation 1970; 42: 437-444.

  28. Pahl NH, Park SC, Anderson RH: Spontaneous closure of ventricular component of an atrioventricular septal defect. Am J Cardiol 1987; 60: 1203-1205.

  29. Ho SY, Russell G, Gerlis LM: Atrioventricular septal defect with septal structures in a 74-year-old. Int J Cardiol 1990; 26: 371-373.

  30. Bharati S, Lev M: The spectrum of common atrioventricular orifice (canal). Am Heart J 1973; 86: 553-561.




2020     |     www.medigraphic.com