Iki Adachi, MD, Siew Yen Ho, PhD, FRCPath, Karen P

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Ventricular Scoop in Atrioventricular Septal Defect: Relevance to Simplified Single-Patch Method Iki Adachi, MD, Siew Yen Ho, PhD, FRCPath, Karen P. McCarthy, BS, Hideki Uemura, MD, FRCS The Annals of Thoracic Surgery Volume 87, Issue 1, Pages 198-203 (January 2009) DOI: 10.1016/j.athoracsur.2008.09.033 Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Diagram showing the measurements made on the left ventricular aspect. (Left lower) To assess the shape of a ventricular component, the depth (d) and intersection (i) of the deepest point of the scoop were obtained. The minimum left ventricular outflow tract (LVOT) diameter was measured at the narrowest part between a border of the scoop and the ventricular free wall. The atrioventricular junction diameter (j) was used for standardization of other values. (Right lower) The ventricular component was examined to determine whether it extended beyond the level of the antero-superior end of the atrioventricular junction. (Ao = aorta; LA = left atrium; LV = left ventricle; SBL = superior bridging leaflet; IBL = inferior bridging leaflet.) The Annals of Thoracic Surgery 2009 87, 198-203DOI: (10.1016/j.athoracsur.2008.09.033) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Photographs illustrating the left ventricular surface of two hearts with the complete form of atrioventricular septal defect with the antero-superior extension (a) and without the extension (b) and one heart with the partial form of atrioventricular septal defect (c). In the heart with the partial form, the left ventricular outflow tract (LVOT) area is separately displayed in the inset. The anatomic atrioventricular junction and the narrowest part of the left ventricular outflow tract are marked with a red line and a white arrow, respectively. (Ao = aorta; LA = left atrium; LV = left ventricle.) The Annals of Thoracic Surgery 2009 87, 198-203DOI: (10.1016/j.athoracsur.2008.09.033) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Measurements on the ventricular component of the septal deficiency (scoop) and the left ventricular outflow tract (LVOT) diameter at the narrowest part in complete forms of atrioventricular septal defect with (C+) and without (C−) antero-superior extension, and partial atrioventricular septal defect (P) are presented as a ratio of the width of the atrioventricular junction. The last column shows no significant difference in the left ventricular outflow tract diameters between hearts with the complete form having a deeper scoop (defined as a depth of 60% or greater) and those having a shallower scoop (depth of less than 60%). §p < 0.05. (NS = not significant.) The Annals of Thoracic Surgery 2009 87, 198-203DOI: (10.1016/j.athoracsur.2008.09.033) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions