LEFT VENTRICULAR ANGIOGRAPHIC ANATOMY OF OSTIUM PRIMUM DEFECT IN THE ADULT

¹ Assistant Professor in Radiology.
² Fellow in Cardiology.
³ Assistant Professor in Cardiology.

Comparison of the left ventricular angiographic anatomy pre- and postoperatively has demonstrated that the surgical repair of both the atrial septal defect and cleft mitral valve in adult patients with an ostium primum defect causes very little change in the characteristic angiographic picture of the left ventricle, the left ventricular outflow tract or the mitral valve.

Of 8 patients studied pre- and postoperatively, all had complete closure of the defect. Postoperatively 3 had persistent mild mitral insufficiency. The radiolucent notch representing the cleft in the anterior leaflet was seen in 6 of 8 cases postoperatively despite suture repair.

The medial border of the left ventricle in systole, which is formed by the displaced anterior leaflet of the mitral valve, was markedly irregular due to the abnormal leaflet in all 8 cases. During diastole the left ventricular outflow tract had a similar appearance in both pre- and postoperative angiograms, with persistence of the typical "gooseneck" deformity.

Left ventricular angiography by retrograde arterial catheterization utilizing cineangiography is the optimal technique for anatomic confirmation of the ostium primum defect and for assessing the presence and severity of mitral regurgitation.

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