Echocardiographic assessment of common atrioventricular canal

Abstract

Common atrioventricular (AV) canal consist of a group of structural heart malformations that share some common features but can vary widely with respect to anatomic features and physiologic manifestations. High quality, non-invasive evaluation can define the anatomic features of the disease and give cardiologists a full appreciation of the hemodynamic issues. Patients with common AV canal frequently require surgical intervention and the importance of non-invasive evaluation in the intra-operative, peri-operative and post-operative periods has grown along with the technology. Echocardiographic technology has progressed rapidly over the last 25 years, revolutionizing the evaluation of structural heart disease. Patients with suspected common AV canal can now be completely evaluated non-invasively in most cases. Using two-dimensional imaging, color and spectral Doppler, the cardiologist can fully assess cardiac anatomy, hemodynamics and ventricular function. The smaller, high resolution transducers introduced in recent years allow for excellent imaging in newborns. The availability of small transesophageal transducers has made intraoperative study available to patients as small as 2.5 kg. The contribution of three-dimensional echocardiography is still in the investigational stages, but it is likely that it will be important for the further delineation of valve anatomy and for the quantitative assessment of valve and ventricular function. This article reviews the current use of echocardiography in the evaluation of common AV canal, including the initial diagnostic evaluation as well as the intra-operative, post-operative and prenatal evaluation.