Atrioventricular septal defect

Atrioventricular septal defect (AVSD), previously known as "common atrioventricular canal" (CAVC) or "endocardial cushion defect", is characterized by a deficiency of the atrioventricular septum of the heart. It is caused by an abnormal or inadequate fusion of the superior and inferior endocardial cushions with the mid portion of the atrial septum and the muscular portion of the ventricular septum. more...

If there is a defect in this septum, it is possible for blood to travel from the left side of the heart to the right side of the heart, or the other way around. Since the right side of the heart contains venous blood with a low oxygen content, and the left side of the heart contains arterial blood with a high oxygen content, it is beneficial to prevent any communication between the two sides of the heart and prevent the blood from the two sides of the heart from mixing with each other.

This type of congenital heart defect is associated with patients with Down syndrome (trisomy 21) or heterotaxy syndromes. 70-80% of patients undergoing surgery for AVSD have trisomy 21.

Diagnosis

VSDs can be detected by cardiac auscultation, they cause atypical murmurs and loud heart tones. Confirmation of findings from cardiac auscultation can be obtained with a cardiac ultrasound (echocardiography) (less invasive) and cardiac catheterization (more invasive).

Treatment

Treatment is surgical. Open surgical procedures require a heart-lung machine and are done with a median sternotomy. Percutaneous endovascular procedures are less invasive and can be done on a beating heart, but are only suitable for certain patients.

Litterature

• Shinebourne EA and Yen Ho S: Atrioventricular Septal Defect: Complete and Partial. Chapter 21 in Gatzoulis MA, Webb GD and Daubeney PEF: Diagnosis and Management of Adult Congenital Heart Disease. Edinburgh, 2003.

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