The "Goose Neck" of the Endocardial Cushion Defect: Anatomic Basis

¹ Department of Pathology, United Hospitals-Miller Division. St. Paul, Minnesota and the Departments of Pediatrics, Radiology, Surgery and Pathology, University of Minnesota, Minneapolis

The "goose neck" deformity as seen in left ventriculograms in the endocardial cushion defect persists after surgical treatment in which the subaortic deficiency of the ventricular septum is built up with prosthetic material and the natural mitral valve is replaced by a prosthesis. Anatomic studies indicate that the diaphragmatic (inflow) aspect of the left ventricle and the ventricular septum are short relative to the outflow length of the ventricular septum. In addition, there is a deficiency in the subaortic aspect of the ventricular septum. The study suggests that the term "goose neck" deformity following correction of the deficiency of the ventricular septum appears to be related to the short nature of the inflow part of the left ventricular wall at its diaphragmatic aspect. The study suggests that the term "goose neck" deformity is better replaced by "goose" deformity, since the deficient posterior wall of the left ventricle outlines the curvature of the back of the "goose" which persists in spite of correction at operation.

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