Atrioventricular septal defect

Atrioventricular septal defects (AVSDs) comprise of a relatively wide range of defects involving the atrial septum, ventricular septum and one or both of the tricuspid or mitral valve. They can represent 2 - 7% of congenital heart defects. All four chambers of the heart communicate therefore both left to right and right to left shunts can occur.

Synonyms
Atrioventricular septal defect
Endocardial cushion defect
AVSD
Atrioventricular septal defect (AVSD)

Associations

Down syndrome (trisomy 21)

Classification

Many have been used but can be broadly divided into

* complete
* incomplete

Radiographic features

Plain film

Not specific but can have cardiomegaly +/- features of pulmonary hypertension and mitral valve insufficiency.

Echocardiography / Ultrasound

Direct visualisation of defect spectrum

Angiography

Can give a classical "Goose neck" sign on a lateral left ventricular angiogram 3

MRI

Direct visualisation of defect spectrum. Can be superior in assessing cardiac chamber dimensions and to assess the presence/extent of ventricular hypoplasia which is a determinant of surgical risk.

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Chest X-ray - Atrioventricular septal defect

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Chest X-ray - Atrioventricular septal defect

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Chest X-ray - Atrioventricular septal defect

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Down Syndrome Infant with Atrioventricular septal defect

Article Author : Dr Yuranga Weerakkody, Radiopaedia

References

  1. 1. Barboza JM, Dajani NK, Glenn LG et-al. Prenatal diagnosis of congenital cardiac anomalies: a practical approach using two basic views. Radiographics. 22 (5): 1125-37.
  2. 2. Wang ZJ, Reddy GP, Gotway MB et-al. Cardiovascular shunts: MR imaging evaluation. Radiographics. 2003;23 Spec No (suppl 1): S181-94. doi:10.1148/rg.23si035503
  3. 3. Ferguson EC, Krishnamurthy R, Oldham SA. Classic imaging signs of congenital cardiovascular abnormalities. Radiographics. 27 (5): 1323-34. doi:10.1148/rg.275065148
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