Cardiac pathologies linked to the atrioventricular canal

By Cristiano Antonino On Apr 22, 2023

We talk about the atrioventricular canal: venous blood from the systemic circulation reaches the heart via the venae cavae that flow into the right atrium

What is the atrioventricular canal

Via the tricuspid valve, the blood will fill the right ventricle which will pump the blood into the pulmonary artery towards the pulmonary circulation where the blood will be oxygenated.

From the lungs, the blood will return to the heart, through the pulmonary veins into the left atrium, past the mitral valve to fill the left ventricle which will pump it into the aorta, into the systemic circulation and then to organs such as the heart itself, the brain, the liver, the kidneys and other organs.

The atrioventricular canal, is a formation deficit of the lower part of the wall separating the two atria, accompanied by a more or less complete fusion of the mitral and tricuspidal valve rings.

In the presence of an interventricular defect one speaks of a complete atrioventricular canal, if the canal is missing it is called partial. There are also intermediate forms.

The combination of these defects will produce a left-to-right passage of blood at the atrial and ventricular level, and varying degrees of mitral and tricuspid valve insufficiency.

The lungs are flooded with torrential blood flow and there is a very high probability of running the risk of developing intensive pulmonary vasculopathy.

Symptoms

The most common symptoms will include growth retardation, recurrent lung infections and often heart failure.

Irreversible hypertensive pulmonary vascular disease will manifest early and without surgical treatment, most patients will be inoperable within a few years.

Thanks to the echocardiogram, it will be possible to get a complete picture of the anatomical situation; cardiac catheterisation will be necessary in order to measure the pressures and resistances of the pulmonary circulation in order to assess the conditions for operability.

Surgery will have to be performed; until a few years ago, early pulmonary artery banding was recommended: the pulmonary artery was narrowed in order to reduce blood flow to the lungs.

Subsequently, after a year, corrective surgery to close the interatrial and interventricular defects and to separate and reconstruct the mitral and tricuspid valves was performed.

Today, it is preferred to proceed with the correction within the first few months of life; surgery is definitive and the bandage will only be performed in cases where the patient is underweight or has other health problems.

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