Cross-sectional and pulsed Doppler echocardiography of the atrioventricular junction of hearts with univentricular atrioventricular connexion

Abstract

The atrioventricular junction of 52 consecutive patients with univentricular atrioventricular connexion was examined by cross-sectional and pulsed Doppler echocardiography. The echocardiographic features were then compared with catheterisation and cineangiographic findings. In the diagnosis of the mode of atrioventricular connexion, cross-sectional echocardiography was superior to cineangiography in differentiating single inlet with absence of one atrioventricular connexion from double inlet with a common atrioventricular valve. Straddling atrioventricular valves were diagnosed by echocardiography alone. Using pulsed Doppler echocardiography, the diagnostic sensitivity of atrioventricular valvar regurgitation was 92.6% and the specificity 100%. By mapping the regurgitant jet with pulsed Doppler echocardiography, an index was derived to evaluate the severity of atrioventricular valvar regurgitation. The indices obtained correlated well with cineangiographic grading on a three-point scale (Spearman rank correlation coefficient: rs = 0.9). Thus, cross-sectional echocardiography coupled with a range-gated Doppler system provide accurate anatomical details of the atrioventricular junction and reliable assessment of atrioventricular valvar regurgitation in patients with univentricular atrioventricular connexion.