Predicting Feasibility of Biventricular Repair of Right-Dominant Unbalanced Atrioventricular Canal Jacques A.M van Son, MD, PhD, Colin K Phoon, MPhil,

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Presentation transcript:

Predicting Feasibility of Biventricular Repair of Right-Dominant Unbalanced Atrioventricular Canal Jacques A.M van Son, MD, PhD, Colin K Phoon, MPhil, MD, Norman H Silverman, MD, Gary S Haas, MD The Annals of Thoracic Surgery Volume 63, Issue 6, Pages 1657-1663 (June 1997) DOI: 10.1016/S0003-4975(97)00230-0

Fig. 1 (A) Various measurements made from apical four-chamber view. The ratio of left atrioventricular valve (LAVV) to total AV valve diameter was calculated as follows: LAVV/(LAVV + rightatrioventricularvalve [RAVV]). Left ventricular and right ventricular long dimensions are represented by arrows in left ventricle (LV) and right ventricle (RV), respectively. (B) The hatched area shows left ventricular area as derived from apical four-chamber view. (C) The hatched area shows right ventricular area as derived from apical four-chamber view. (LA = left atrium; RA = right atrium.) The Annals of Thoracic Surgery 1997 63, 1657-1663DOI: (10.1016/S0003-4975(97)00230-0)

Fig. 2 Hatched area shows cross-sectional true left ventricular area (LV) imaged just below level of atrioventricular valve. Left ventricular volume was estimated by modification of method used by Rhodes and co-workers [[13]] using the equation: volume = 0.83 × LVarea × LVlongdimension. (RV = right ventricle.) The Annals of Thoracic Surgery 1997 63, 1657-1663DOI: (10.1016/S0003-4975(97)00230-0)

Fig. 3 In estimating preoperative potential left ventricular cross-sectional area, an imaginary line (A) is drawn from one end to the other of the crescent-shaped left ventricle (LV). The potential left ventricular area is approximated by twice the hatched area bounded by line A and the posterior left ventricular endocardium. (RV = right ventricle.) The Annals of Thoracic Surgery 1997 63, 1657-1663DOI: (10.1016/S0003-4975(97)00230-0)

Fig. 4 Preoperative echocardiographic views of right ventricle (RV) and left ventricle (LV) in (A) short-axis and (B) apical four-chamber views demonstrating compressed and hypoplastic-appearing LV. After biventricular repair of right-dominant unbalanced atrioventricular canal, the LV is seen to assume relatively normal size in both (C) short-axis and (D) apical four-chamber views. The Annals of Thoracic Surgery 1997 63, 1657-1663DOI: (10.1016/S0003-4975(97)00230-0)