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Atrioventricular Septal Defect

An atrioventricular septal defect (AVSD) is a congenital heart defect where there is a deficiency in the septum that separates the upper chambers (atria) and lower chambers (ventricles) of the heart. It can range from a partial defect involving an atrial septal defect and cleft mitral valve, to a complete defect involving both the atrial and ventricular septa along with a common atrioventricular valve. AVSD is associated with Down syndrome and accounts for 17% of congenital heart defects. It is caused by abnormal fusion of septal tissues during heart development. Treatment involves surgical repair to close defects and reconstruct heart valves.

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Manishta Menaka Dhuromsingh
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547 views3 pages

Atrioventricular Septal Defect

An atrioventricular septal defect (AVSD) is a congenital heart defect where there is a deficiency in the septum that separates the upper chambers (atria) and lower chambers (ventricles) of the heart. It can range from a partial defect involving an atrial septal defect and cleft mitral valve, to a complete defect involving both the atrial and ventricular septa along with a common atrioventricular valve. AVSD is associated with Down syndrome and accounts for 17% of congenital heart defects. It is caused by abnormal fusion of septal tissues during heart development. Treatment involves surgical repair to close defects and reconstruct heart valves.

Uploaded by

Manishta Menaka Dhuromsingh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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ATRIOVENTRICULAR SEPTAL DEFECT

(AVSD)
deficiency of the atrioventricular septum of the heart

Classification:
Partial AVSD = A primum atrial septal defect and cleft mitral valve but no direct
intraventricular communication (ostium primum defect).

Complete AVSD = defects of both the primum atrial septum and inlet ventricular septum and
the presence of a common atrioventricular valve

Incidence and Epidemiology


>Associated to patients with Down’s Syndrome (35-40% DS pts have an AVSD)
>17% of CHD
Pathophysiology:
It is caused by an abnormal or inadequate fusion of the superior and inferior endocardial
cushions with the mid portion of the atrial septum and the muscular portion of the ventricular
septum

 L→R shunting occurs at both atrial and ventricular levels with shunting from LV →RA
(due to absence of AV septum)
PHTN and ↑ tendency to develop PVR leads to R→L shunting which in turn results in
cyanosis (Eisenmenger Syndrome)
 V valvular insufficiency

Signs and Symptoms


>Clinical presentation depends on degree of mitral regurgitation.
>No MR → no significant symptoms
>Severe MR → poor feeding, tachypnea, labored breathing, exercise intolerance
>may trigger CHF in older patients

On auscultation;
>Hyperactive precordium
>Normal/ accentuared 1st heart sound
>Wide, fixed splitting ofS2
>Pulmonary systolic ejection mummur w/ thrill
>Holosystolic mumur @apex w/ radiation to axilla
>Mid diastolic rumbling mumur @ LSB
Differential Diagnoses
 Coronary Sinus Atrial Septal Defects
 Ostium Secundum Atrial Septal Defects
 Partial Anomalous Pulmonary Venous Connection
 Pediatric Mitral Valve Insufficiency
 Pediatric Mitral Valve Prolapse
 Sinus Venosus Atrial Septal Defects

Clinical Examination
1. Chest Xray
>Prominent pulmonary artery segment + dense pulmonary vascular markings
>Cardiac enlargement, especially (RA & RV)

2. Echocardiography
>Diagnostic method of choice

3. MRI
>useful for evaluating shunt severity, expressed quantitatively as the ratio of pulmonary
flow to systemic flow (Qp/Qs).

4. ECG
>Prolonged PR interval
>L axis deviation with Rventricular hypertrophy

Treatment
1. Treatment for CHF is occasionally required if MR cannot be adequately surgically
reduced
2. Surgical: patch closure of the atrial septal defect (ASD), mitral valve annuloplasty, or
cleft closure

*Can also use furosemide, ACEi and digoxin to ease symptoms prior to repair

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