Lazcano-Bautista S, Burgueño-Amador G, Alva C

Language: Spanish
References: 10
Page: 11-16
PDF size: 133.72 Kb.

ABSTRACT

Objective: To evaluate the feasibility and accuracy of the sequential segmental analysis (SSA) to diagnose congenital heart diseases. Material and methods: 100 cardiopulmonar specimens were analyzed according with the sequential segmental analysis. The atrial situs, atrioventricular (AVC) and ventriculoarterial connections (VAC) were defined, finally associated lesions were observed. Results: From 100 specimens, 91 had situs solitus (SS), 6 inversus (SI) and 3 isomerism (2 right isomerism and 1 left isomerism). The AVC in these hearts were: 89 biventricular, 80 (90%) concordant, 6 (6.7%) discordant and 3 (3.3%) ambiguous (2 right topology an 1 left topology). The univentricular AVC were 11, 4 (36%) had absent left AVC (mitral atresia), 3 (27%) absent right AVC (tricuspid atresia), 2 (18%) double inlet right ventricle (DIRV), 1 double inlet left ventricle (DILV) and 1 (9%) double inlet undetermined ventricle. The VAC in SS were: 52 (57%) concordant, 13 (14%) discordant, 6 (6.6%) double outlet right ventricle (DORV), 20 (22%) with single outlet (13 pulmonary atresia , 5 aortic atresia and 2 common arterial trunk). The VAC in SI were: concordant in one, (16.7%), discordant 3 (50%) and DORV in 2 (33.3%). In the hearts with isomerism, the VAC were concordant in one, DORV in one and single outlet in another (pulmonary atresia). The associated anomalies were ASD (67%), PAD (51%) and VSD (53%). Conclusions: The SSA was and effective and accurate tool to codify clear and completely the congenital heart disease. It is suggested that if the SSA is normal to describe this situation as a Normal Basic Heart Organization and then to describe the associated anomalies.

REFERENCES

1. Tynan MJ, Becker AE, Macartney FJ, Jimenez MQ, Anderson RH: Nomenclature and classification of congenital heart disease. Br Heart J, 1979; 41: 544-553.

2. Anderson RH, Ho SY: Sequential segmental analysis: description and categorization for the millennium. Cardiol Young 1997; 7: 98-116.

3. De la Cruz MV, Berrazueta JR, Arteaga M, Attié F, Soni J: Rules for diagnostic of arterioventricular discordances and spatial identification of ventricles. Br Heart J 1976; 38: 341-354.

4. De la Cruz MV, Nadal-Ginard B: Rules for diagnostic of visceral situs, truncoconal morphologies and ventricular inversions. Am Heart J 1972; 84: 9-32.

5. Van Praagh R, Van Praagh S, Vlad P, Keith JD: Anatomic types of congenital dextrocardia. Diagnostic and embryologic implications. Am J Cardiol 1964; 13: 510-531.

6. Attié F: Diagnóstico anatómico de las cardiopatías congénitas. Arch Inst Cardiol Mex 2004; 74, supl 1: S13-S17.

7. Alva C, Ibarra-Pérez C: Comprensión y diagnóstico de las cardiopatías congénitas complejas I. Bol Med Hosp Infant Mex 1992; 49: 39-47.

8. Anderson RH, Becker AE, Freedom RM, Macartney FJ, Quero JM, Shinebourne EA, et al: Sequential segmental analysis of congenital heart disease. Pediatr Cardiol 1984; 5: 281-288.

9. Anderson RH: How should we optimally describe complex congenitally malformed hearts? Ann Thorac Surg 1996; 62: 710-716.

10. Vesterby A, Nielsen K, Borg L, Paulsen S, Baandrup U: Congenital heart malformations in Jutland, Denmark: a three year necropsy study in children aged 0-14 years. Br Heart J 1987; 58: 653-658.