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Norman H. Silverman
Doff B. McElhinney
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Ann Thorac Surg 1998;66:653-658
© 1998 The Society of Thoracic Surgeons

Supplement

Atrioventricular valve dysfunction: evaluation by doppler and cross-sectional ultrasound

Norman H. Silverman, MDa, Doff B. McElhinney, MDa

a Division of Pediatric Cardiology, Department of Pediatrics, University of California, San Francisco, California, USA

Address reprint requests to Dr Silverman, University of California, San Francisco, Box 0214, M342A, San Francisco, CA 94143-0214
e-mail: (norman_silverman{at}pedcardgateway.ucsf.edu)

Presented at the Workshop on "One and One-Half Ventricle Repairs," Gubbio, Italy, Dec 6–7, 1996.

Abstract

Background. An important factor in the management and outcome of patients with complex univentricular or partial biventricular repair is atrioventricular valve function. Cross-sectional and Doppler echocardiography are versatile tools for the evaluation of atrioventricular valve function. However, it is important to understand the physics and applications of this technology to appreciate the strengths and limitations of echocardiography in this application.

Methods and Results. In this review, we discuss the preoperative and intraoperative echocardiographic evaluation of atrioventricular valve function in congenital heart disease. The focus is on atrioventricular valve regurgitation, which is the most common type of dysfunction in patients with univentricular or partial biventricular heart disease. We emphasize an understanding of basic jet physics, as well as technical considerations in the evaluation of atrioventricular valve function, with illustrations from our own experience.

Conclusions. Cross-sectional and Doppler cardiac ultrasound is the optimal tool for evaluation of atrioventricular valve function in the current era. Although the issue of quantifying regurgitant jets is not yet fully resolved, echocardiography allows for complete qualitative assessment of the anatomic and functional features that influence the function of the atrioventricular valves.






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