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Ann Thorac Surg 2009;87:1499-1500. doi:10.1016/j.athoracsur.2009.03.006
© 2009 The Society of Thoracic Surgeons
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Original Articles: Pediatric Cardiac

Invited Commentary

Robert H. Anderson, MD

60 Earlsfield Rd, London, SW18 3DN United Kingdom

(Email: r.anderson@ich.ucl.ac.uk).

The first 20% of the full text of this article appears below.

In the accompanying article, Adachi and colleagues [1] provide a superb account of the rare combination of hearts possessing common junctions at both atrioventricular and ventriculo-arterial levels. As they describe, most previous accounts of this combination are based on examination of autopsied specimens. Although they suggest that "many more cases" have been described after such postmortem examination, this has to be considered in the context of only two accounts of successful surgical repair. In my own experience, the combination of common atrioventricular and ventriculo-arterial junctions is very rare. The authors are to be commended on gathering together six examples of this phenotypic variant.

It is particularly notweworthy that in all six of their examples, the common trunk arose exclusively from the right ventricle. In this respect, it is then of further note (according to their table) that five of the six leaflets of the truncal valve were in fibrous continuity with the superior bridging leaflet of the common atrioventricular valve. This means that in an arrangement that is directly analogous to the double outlet from the right ventricle, albeit though . . . [Full Text of this Article]


Related Article

Common Arterial Trunk With Atrioventricular Septal Defect: New Observations Pertinent to Repair
Iki Adachi, Siew Yen Ho, Margot M. Bartelings, Karen P. McCarthy, Anna Seale, and Hideki Uemura
Ann. Thorac. Surg. 2009 87: 1495-1499. [Abstract] [Full Text] [PDF]





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