Abstract
We present an unusual variant of partial atrioventricular septal defect with double outlet left atrium (DO LA). Diagnosis was established during a routine examination a 10-year-old child involved in sports using two-dimensional echocardiography and confirmed using magnetic resonance imaging. The separate communications between the left atrium, the left ventricle and the right ventricle was diagnosed in combination with small atrial septal defect of ostium primum type and the trileaflet left atrioventricular valve, in absence of obstruction and any significant valve insufficiency. An absence of clinical symptoms, indications for therapeutic and surgical treatment have not been established. This observation complements the previous publications of DO LA, where this anomaly was an element of complex cardiac heart defects, and also illustrates the exceptional anatomical variability of the open atrioventricular septal defect.
References
- Shetkar S., Kothari S.S. Double-outlet left atrium: ventriculoatrial malalignment defect. Ann. Pediatr. Cardiol. 2013; 6: 158–61. DOI: 10.4103/0974-2069.115266
- Horiuchi T., Saji K., Osuka Y., Sato K., Okada Y. Successful correction of double outlet left atrium associated with complete atrioventricular canal and l-loop double outlet right ventricle with stenosis of the pulmonary artery. J. Cardiovasc. Surg. 1976; 17: 157–61.
- Bini R.M., Pellegrino P.A., Mazzucco A., Gallucci V., Milanesi O., Maddalena F. et al. Tricuspid atresia with double-outlet left atrium. Chest. 1980; 78: 109–11. DOI: 10.1378/ chest.78.1.109
- Suzuki Y., Hamada Y., Haneda K., Horiuchi T., Ogata H. Double outlet left atrium with intact ventricular septum. Ann. Thorac. Surg. 1988; 45: 332–4. DOI: 10.1016/s00034975(10)62476-9
- Bhat Y.A., Pratap H., Dagar K.S., Awasthy N. Double-outlet left atrium: Successful repair of an extremely rare anomaly. Ann. Ped. Cardiol. 2018, 11: 204. DOI: 10.4103/ apc.apc_136_17
- Anderson R.H., Wessels A., Vettukattil J.J. Morphology and morphogenesis of atrioventricular septal defect with common atrioventricular junction. World J. Pediatr. Congenit. Heart Surg. 2010; 1: 59–67. DOI: 10.1177/2150135109360813
- Kiraly L., Hubay M., Cook A.C., Ho S.Y., Anderson R.H. Morphologic features of the uniatrial but biventricular atrioventricular connections. J. Thorac. Cardiovasc. Surg. 2007; 133: 229–34. DOI: 10.1016/j.jtcvs.2006.08.067
- Anderson R.H. How best to explain unexpected arrangements of the atrioventricular valves? Ann. Pediatr. Cardiol. 2013; 6: 152–4.
- Van Praagh R. What are double-outlet left atrium and double-outlet right atrium? Ann. Pediatr. Cardiol. 2013; 6 (2): 155–7.
- Kaski J.P., Wolfenden J., Josen M., Daubeney P., Shinebourne E.A. Can atrioventricular septal defects exist with intact septal structures? Heart. 2005; 92: 832–5. DOI: 10.1136/hrt.2005.069278
About the authors
- Yuriy Yu. Kornoukhov, Pediatric Cardiologist, orcid.org/0000-0002-4775-8543
- Mariya V. Il’ina, Pediatric Cardiologist, orcid.org/0000-0002-6930-9343
- Mariya M. Belyaeva, Pediatric Cardiologist, orcid.org/0000-0002-1369-7754
- Valeriy V. Khovrin, Dr. Med. Sc., Chief Researcher, orcid.org/0000-0002-6720-4126
- Vladimir N. Il’in, Dr. Med. Sc., Professor, Cardiovascular Surgeon, Head of Department, orcid.org/0000-0003-4162-068X