CARDIOANGIOGRAPHIC EVALUATION OF THE RELATIONSHIP BETWEEN ATRIOVENTRICULAR AND SEMILUNAR VALVES: ITS DIAGNOSTIC IMPORTANCE IN CONGENITAL HEART DISEASE

The anatomopathologic relationships between atrioventricular and semilunar valves are helpful in classifying congenital heart disease. In our experience this relationship presents a specific angiocardiographic aspect in each anomaly involving the development of conal myocardium. This was studied in 35 patients with corrected transposition of the great vessels, 25 with complete transposition, 9 with persistent truncus arteriosus, 6 with origin of both great vessels from the right ventricle and 55 with tetralogy of Fallot for a total of 130 cases. In tetralogy of Fallot and in persistent truncus arteriosus the atrioventricular-semilunar valve relationship was found to be normal. In contradistinction, in corrected transposition there was continuity between the right atrioventricular and the pulmonary valves and noncontinuity on the left side. In complete transposition the left atrioventricular valve was continuous with the pulmonary valve. In origin of both great vessels from the right ventricle no continuity between the atrioventricular and semilunar valves was present.

This approach was particularly helpful in differentiating between borderline cases of transposition complexes with or without dextroversion or dextrocardia, and tetralogy of Fallot from cases with origin of both great vessels from the right ventricle with obstruction to pulmonary flow.

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