Atrioventricular discordance. Cross-sectional echocardiographic--morphological correlative study.

Abstract

Forty-nine patients with atrioventricular discordance were studied using cross-sectional echocardiography. The atrial arrangement was consistently predicted by echocardiographic analysis of either the patterns of pulmonary and systemic venous drainage or the arrangement of the great vessels within the upper abdomen. The ventricular arrangement was consistently predicted by direct identification of ventricular morphology. In hearts with two atrioventncular valves (47 patients) this was best derived by determining the pattern of implantation of the valve chordae to the ventricular myocardium. This proved to be more reliable in identifying ventricular morphology than either the analysis of trabecular patterns or the identification of valve leaflet morphology. In hearts with a common atrioventricular valve (two patients) ventricular arrangement had to be determined by identifying ventricular trabecular patterns.