3Dechocardiography
the art of defining cardiac morphology

Post-Op AVSD

Assessment of patients following AVSD repair for residual defects and AV valve function is very important. Focus on Valve morphology, presence and degree of AV valve regurgitation, LVOT obstruction and mechanism of LVOT obstruction are some of the major points of interest when doing 3D echocardiography. Here we discuss some of these issues.

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Post surgical repair of AVSD. LAA=Left atrial appendage, SBL=Superior bridging leaflet, IBL=Inferior bridging leaflet, Ao=Aorta. The suture line between SBL and IBL along the point of apposition is clearly visible. Note the area above the SBL and the unwedged position of the aorta with the unsupported part of the LVOT bulging into the LA during the ventricular systole. This is the area which has the potential for subaortic obstruction if a single patch technique is used for repair of the AVSD (If the VSD component has an anterio-superior extension "scoop" in to the LVOT.

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View from the ventricle.

The suture line across the bridging leaflets are more pronounced in this view. There is restriction of opening of the left AV valve. However, valve incompetence or its degree and the mechanism of regurgitation is not evident.

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Post-Op AVSD Assessment of patients following AVSD repair for residual defects and AV valve function is very important. Focus on Valve morphology, presence and degree of AV valve regurgitation, LVOT obstruction and mechanism of LVOT obstruction are some of the major points of interest when doing 3D echocardiography. Here we discuss some of these issues. Post surgical repair of AVSD. LAA=Left atrial appendage, SBL=Superior bridging leaflet, IBL=Inferior bridging leaflet, Ao=Aorta. The suture line between SBL and IBL along the point of apposition is clearly visible. Note the area above the SBL and the unwedged position of the aorta with the unsupported part of the LVOT bulging into the LA during the ventricular systole. This is the area which has the potential for subaortic obstruction if a single patch technique is used for repair of the AVSD (If the VSD component has an anterio-superior extension "scoop" in to the LVOT. View from the ventricle. The suture line across the bridging leaflets are more pronounced in this view. There is restriction of opening of the left AV valve. However, valve incompetence or its degree and the mechanism of regurgitation is not evident. View from the ventricular aspect: The LVOT with aortic valve opening is seen just anterior to the anterior bridging leaflet. Seconday chordae can be seen extending from the base of the bridging leaflets going to the interventricular septum. Absence of any sutures along the line of apposition is very evident at the time of the primary repair, which has contributed to the AV valve regurgitation along the point of apposition.

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View from the atria. The top of the left and right atria is cut off to visualize the left and right AV valves. The trifoliate closure of the left AV valve is seen and the LA is grossly dilated.

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