Author + information
- Received December 6, 1994
- Revision received March 16, 1995
- Accepted March 31, 1995
- Published online August 1, 1995.
- Gunnlaugur Sigfússon, MD,
- JoséA. Ettedgui, MD, FACC,
- Norman H. Silverman, MD, FACC and
- Robert H. Anderson, MD, FRCPath1
- ↵1Address for correspondence: Dr. Robert H Anderson, Department of Paediatrics, National Heart and Lung Institute, Dovehouse Street, London SW3 6LY, England, United Kingdom.
Objectives. This study sought to ascertain the surgical anatomy of a cleft in the left atrioventricular (AV) valve.
Background. Important morphologic differences exist between hearts with a cleft in the anterior leaflet of an otherwise normal mitral valve and those with a so-called cleft in the left AV valve when there is an AV septal defect, but it has been customary to link the lesions together on developmental grounds.
Methods. Eight autopsied specimens with a cleft in the aortic (or anterior) leaflet of the mitral valve were studied in detail, and echocardiograms from 21 patients with such a cleft were compared with the specimens and with findings typical of the so-called partial AV canal and other forms of AV septal defect.
Results. The structure and direction of the cleft, location of the papillary muscles within the left ventricle and AV junctional morphology of hearts with an otherwise normally structured mitral valve were significantly different from typical findings in hearts with AV septal defects.
Conclusions. It is necessary to distinguish morphologically a cleft in an otherwise normally structured mitral valve in hearts with separate right and left AV junctions from the trifoliate left component of a common AV valve in hearts with an AV septal defect and a common AV junction because the disposition of the AV conduction tissues varies markedly between the lesions.
☆ During the course of this study Dr. Silverman was on study leave from the Department of Pediatrics, Division of Cardiology, University of California San Francisco, San Francisco, California, and Dr. Anderson was on study leave from the National Heart and Lung Institute, London, England, United Kingdom and was supported by the Patrick Dick Memorial Fund, Pittsburgh, Pennsylvania and the Joseph Levy Foundation and the British Heart Foundation, London, England, United Kingdom.
All editorial decisions for this article, including selection of referees, were made by a Guest Editor. This policy applies to all articles with authors from the University of California San Francisco.
- Received December 6, 1994.
- Revision received March 16, 1995.
- Accepted March 31, 1995.