The Value of Three Dimensional Echocardiography in the Diagnosis and Surgical Design for Children with Atrioventricular Septal Defect

  • Miss Kaihua Yang, Shanghai Children’s Medical Center, Shanghai Jiaotong University, China
  • Dr Kun Sun, Department of Pediatric Cardiology, Shanghai Children’s Medical Center, China
  • Miss Lanping Wu, Shanghai Children’s Medical Center, Shanghai Jiaotong University, China
  • Mr Lisheng Qiu, Shanghai Children’s Medical Center, Shanghai Jiaotong University, China

    • Objective: To evaluate the value of three dimensional echocardiography(3DE) in the diagnosis for atrioventricular septal defect(AVSD), and explore new quantitative parameters for pre-surgical design.
    Methods: 32 consecutive patients with AVSD were randomly enrolled, 23 of them had surgery after 3DE. QLAB and self-designed Cadio4DViewer software were used for analysis. The anatomical information, projective area of common atrioventricular valve annulus(CVa), post-operative area of left atrioventricular valve(LAVV) annulas (MVa), area of bridge valves of LAVV(A+P) and corresponded total area of LAVV(T) were measured. The solid configuration of common valve annulus was demonstrated by Cadio4DViewer.
    Results: Both A+P/T and MVa/CVa had significant relationship with the change of degree of LAVV regurgitation (MRafter-MRpre), the value of R was 0.90 and -0.73. There was distinct separation of the value of A+P/T and MVa/CVa between patients had or not have improvement of LAVV function postoperatively.
    Conclusion: 3DE is useful in the pre-surgical design for AVSD. It is important to make sure the percentage of the area of bridge valves is greater than 50% of the total area of the LAVV when separating the bridge valve. Finally, the annulus of common valve is not planar, it’s more solid and complex than ever thought before.