Outdoor atrioventricular canal
Outdoor atrioventricular canal - a combined congenital heart disease in which there is a connection between the atria and the ventricles due to a defect atrial and ventricular walls, as well as the splitting of the leaflets of the mitral and tricuspid valves.The frequency of this defect is about 2-3% of all congenital heart defects and 26% of cases of atrial septal defect (LA Bokeria, VI Burakovsky).Defect occurs predominantly in children during the first years of life, because of the severe circulatory disorders, most patients die early.
Reset arterial (oxygen-rich) blood from the left heart in the right form at partial atrioventricular canal is open at the level of the atria.At the same time through a split flap of the mitral valve (between the left atrium and ventricle) of blood flow is directed from the left ventricle into the left atrium (t. E. On the contrary).Such a condition in which the blood travels in left ventricular reducing back through the left atrium is not fully stocked leaflets is re
At full form of open atrioventricular canal especially early in the growing high-rise in pressure in the pulmonary artery, which leads to the formation of sclerotic phase (See above.) In the first years of a child's life.Related narrowing (stenosis) of the pulmonary artery makes vice more favorable, because they do not develop pulmonary hypertension.
The simplest and most common classification is a classification that distinguishes three forms of vice.The partial form is a primary atrial septal defect (ASD) and is always accompanied by splitting or deformation of the anteromedial leaflet of the mitral valve.Complete the form - a single channel formed by the primary atrial septal defect, atrioventricular valves located below the ventricular septal defect (VSD) and the total gap separating septal mitral and tricuspid valves.When an intermediate form of the defect, both separate and do not form a single channel, partition both valve flaps are split, but splitting it does not reach their base and does not form a common gap.
open atrioventricular canal diagnosis is often made in the first days of life.This is particularly clearly the data that gets the doctor auscultation of the heart.In addition, the lag in physical development, repeated pneumonia, loss of appetite, fatigue during feeding, signs of heart failure in the form of rapid breathing and heartbeat, congestive wheezing in the lungs and increase the size of the liver are characteristic of children with the full form of open atrioventricular canal in the first days or monthslife.In children with an incomplete form of open atrioventricular canal during the onset of symptoms and severity of the condition determined by the severity of the reverse flow of blood from the left ventricle into the left atrium during mitral insufficiency.In moderate mitral valve disease for close to that in isolated atrial septal defect, whereas a significant reverse current of blood to the first days of the child's condition is usually heavy.
With increased early heart develops heart hump.When the feeling of the heart is determined by shaking the chest.When listening to the doctor reveals the characteristic of this vice noise picture.Additional research methods, conduct which is necessary to confirm or refute the diagnosis of congenital heart disease are ECG, PCG (phonocardiography, t. E. The graphic registration of heart murmurs), cardiac ultrasound, cardiac catheterization cavities with the introduction of a contrast agent and subsequent X-ray examination of the chest.
About 50% of children with atrioventricular canal open die in the first year of life.All children with symptoms of heart failure prescribed cardiac glycosides (digoxin) and diuretics.In most cases, the effect of medical treatment insignificant.This raises the need for surgical correction of the defect.The mortality rate after surgery is 25-50%.