|
|
| (27 intermediate revisions by 6 users not shown) |
| Line 1: |
Line 1: |
| {{Infobox_Disease | | | __NOTOC__ |
| Name = Atrioventricular septal defect |
| | {{Atrioventricular septal defect}} |
| Image = |
| | {{CMG}}; '''Associate Editor-In-Chief:'''[[Priyamvada Singh|Priyamvada Singh, MBBS]] [[mailto:psingh13579@gmail.com]]; '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [[mailto:kfeeney@elon.edu]] |
| Caption = |
| |
| DiseasesDB = 31910 |
| |
| ICD10 = {{ICD10|Q|21|2|q|20}} |
| |
| ICD9 = {{ICD9|745.6}} |
| |
| ICDO = |
| |
| OMIM = |
| |
| MedlinePlus = |
| |
| eMedicineSubj = med |
| |
| eMedicineTopic = 670 |
| |
| MeshName = Endocardial+Cushion+Defects |
| |
| MeshNumber = C14.240.400.560.350 |
| |
| }}
| |
| {{Template:Atrioventricular septal defect}}
| |
| {{CMG}}
| |
|
| |
|
| | ==[[Atrioventricular septal defect overview|Overview]]== |
|
| |
|
| '''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]].
| | ==[[Atrioventricular septal defect classification|Classification]]== |
|
| |
|
| A variety of different classifications have been used, but the defects are usefully divided into "partial" and "complete" forms. In the partial AVSD, there is a defect in the primum or inferior part of the atrial septum but no direct intraventricular communication (ostium primum defect). In the complete AVSD, there is a large ventricular component beneath either or both the superior or inferior bridging leaflets of the AV valve.
| | ==[[Atrioventricular septal defect pathophysiology|Pathophysiology]]== |
|
| |
|
| If there is a defect in the 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.
| | ==[[Atrioventricular septal defect causes|Causes]]== |
|
| |
|
| This type of congenital heart defect is associated with patients with [[Down syndrome]] (trisomy 21) or heterotaxy syndromes.<ref>Report of the New England Regional Infant Cardiac Program. Pediatrics 1980;65(suppl):441–444.</ref> Forty-five percent of children with Down syndrome have congenital heart disease. Of these, 35–40% have AV septal defects.<ref>Al-Hay AA et al: Complete atrioventricular septal defect, Down syndrome and surgical outcome: Risk factors. Ann Thorac Surg 2003;75:412.</ref>
| | ==[[Atrioventricular septal defect differential diagnosis|Differentiating Atrioventricular septal defect from other Disorders]]== |
|
| |
|
| ==Diagnosis== | | ==[[Atrioventricular septal defect epidemiology and demographics|Epidemiology and Demographics]]== |
| AVSDs can be detected by [[auscultation|cardiac auscultation]], they cause atypical murmurs and loud heart tones. Confirmation of findings from cardiac auscultation can be obtained with a cardiac [[Medical ultrasonography|ultrasound]] ([[echocardiography]]) (less invasive) and [[cardiac catheterization]] (more invasive).
| |
|
| |
|
| Tentative diagnosis can also be made in utero via fetal echocardiogram. An AVSD diagnosis made before birth is a marker for Down syndrome, although other signs and further testing are required before any definitive confirmation of either can be made.
| | ==[[Atrioventricular septal defect risk factors|Risk Factors]]== |
|
| |
|
| ==Treatment== | | ==[[Atrioventricular septal defect natural history|Natural History, Complications, and Prognosis]]== |
| Treatment is surgical and involves closure of the atrial and ventricular septal defects and restoration of a competent left AV valve as far as is possible. Open surgical procedures require a [[heart-lung machine]] and are done with a [[median sternotomy]]. [[Percutaneous|Percutaneous endovascular]] procedures are less invasive and can be done on a beating heart, but are only suitable for certain patients. Surgical mortality in experienced centers is less than 10 percent for complete defects and less than 5 percent for partial defects.<ref>Kirklin J, Barratt-Boyes B, ed. Cardiac Surgery, New York: Wiley, 1986:463–497.</ref>
| |
|
| |
|
| Infants born with AVSD are generally in sufficient health to not require immediate corrective surgery. If surgery is not required immediately after birth, the newborn will be closely monitored for the next several months, and the operation held-off until the first signs of lung distress or heart failure. This gives the infant time to grow, increasing the size of, and thereby the ease of operation on, the heart, as well as the ease of recovery. Infants will generally require surgery within three to six months, however, they may be able to go up to two years before the operation becomes necessary, depending on the severity of the defect.<ref>Hay, WW, et al. 2007. ''Lange Current Pediatric Diagnosis and Treatment, 18th ed.'' New York: McGraw-Hill.</ref>
| | ==Diagnosis== |
| | [[Atrioventricular septal defect history and symptoms|History and Symptoms]] | [[Atrioventricular septal defect physical examination|Physical Examination]] | [[Atrioventricular septal defect laboratory tests|Laboratory Findings]] | [[Atrioventricular septal defect electrocardiogram | Electrocardiogram]] | [[Atrioventricular septal defect chest x ray|Chest X Ray]] | [[Atrioventricular septal defect MRI|MRI]] | [[Atrioventricular septal defect CT|CT]] | [[Atrioventricular septal defect echocardiography or ultrasound|Echocardiography]] | [[Atrioventricular septal defect cardiac catheterization|Cardiac Catheterization]] |
|
| |
|
| ==References== | | ==Treatment== |
| <references/>
| | [[Atrioventricular septal defect medical therapy|Medical Therapy]] | [[Atrioventricular septal defect surgery|Surgery]] | [[Atrioventricular septal defect prevention|Prevention]] | [[Atrioventricular septal defect cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Atrioventricular septal defect future or investigational therapies|Future or Investigational Therapies]] |
|
| |
|
| ==Additional Resources== | | ==Related Chapters== |
| | |
| * 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.
| |
| | |
| ==External links==
| |
| * [http://heartcenter.seattlechildrens.org/conditions_treated/atrioventricular_septal_defect.asp Atrioventricular Septal Defect information] from Seattle Children's Hospital Heart Center
| |
| * [http://www.cincinnatichildrens.org/health/heart-encyclopedia/anomalies/avsd.htm AVSD information, diagram and flash animation]from Cincinnati Children's Hospital Medical Center
| |
| * [http://www.med.umich.edu/cvc/mchc/paratrv.htm Overview and diagram at umich.edu]
| |
| * [http://www.fairview.org/healthlibrary/content/ca_ecushion_art.htm Diagram at fairview.org]
| |
| * [http://www.dhg.org.uk/atrioventricularseptaldefect.htm Explanation and simple diagram ]from '''Down's Heart Group''', a UK based charity offering support and information relating to heart problems associated with Down's Syndrome.
| |
| | |
| ==See also==
| |
| *[[Atrial septal defect]] | | *[[Atrial septal defect]] |
| *[[Congenital heart disease]] | | *[[Congenital heart disease]] |
| Line 58: |
Line 33: |
| *[[Ventricular septal defect]] | | *[[Ventricular septal defect]] |
|
| |
|
| {{Congenital malformations and deformations of circulatory system}}
| |
|
| |
| [[de:Atrio-ventrikulärer Septumdefekt]]
| |
| [[fr:Canal atrio-ventriculaire]] | | [[fr:Canal atrio-ventriculaire]] |
| [[nn:Atrioventrikulær septumdefekt]] | | {{WH}} |
| [[uk:Атріовентрикулярний септальний дефект]]
| | {{WS}} |
| | [[CME Category::Cardiology]] |
|
| |
|
| [[Category:Cardiology]] | | [[Category:Cardiology]] |
| | | [[Category:Congenital heart disease]] |
| {{WH}}
| | [[Category:Pediatrics]] |
| {{WS}}
| | [[Category:Disease]] |