Third time lucky: challenging secundum atrial septal defect

2019 ◽  
Vol 29 (09) ◽  
pp. 1202-1205
Author(s):  
Maria Victoria Ordoñez ◽  
Sarah Moharem-Elgamal ◽  
Radwa Bedair
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Young Patients ◽  
Symptomatic Improvement ◽  
Secundum Atrial Septal Defect ◽  
Interatrial Communication ◽  
The Third ◽  
Septal Defects ◽  
Clinical Presentations ◽  
Clinical Heart Failure

AbstractSecundum atrial septal defect is the most common form of interatrial communication. Atrial septal defects can present in young adults with a variety of clinical presentations, including breathlessness on effort, palpitations, or stroke. Clinical heart failure and resting desaturation are both rarely seen in young patients. We present a case of a young man with a secundum atrial septal defect and a diagnosis of constrictive pericarditis, only made after two attempts at surgical correction of the atrial septal defect, with pericardiectomy at the third attempt and subsequent symptomatic improvement.

scholarly journals Identification and Morphogenesis of Vestibular Atrial Septal Defects

2020 ◽  
Vol 7 (3) ◽  
pp. 35
Author(s):  
Rohit S. Loomba ◽  
Justin T. Tretter ◽  
Timothy J. Mohun ◽  
Robert H. Anderson ◽  
Scott Kramer ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Leading Edge ◽  
Atrial Septum ◽  
Mouse Embryos ◽  
University Of Florida ◽  
Interatrial Communication ◽  
Septal Defects ◽  
Inferior Portion ◽  
The University

Background: The vestibular atrial septal defect is an interatrial communication located in the antero-inferior portion of the atrial septum. Reflecting either inadequate muscularization of the vestibular spine and mesenchymal cap during development, or excessive apoptosis within the developing antero-inferior septal component, the vestibular defect represents an infrequently recognized true deficiency of the atrial septum. We reviewed necropsy specimens from three separate archives to establish the frequency of such vestibular defects and their associated cardiac findings, providing additional analysis from developing mouse hearts to illustrate their potential morphogenesis. Materials and methods: We analyzed the hearts in the Farouk S. Idriss Cardiac Registry at Ann and Robert H. Lurie Children’s Hospital in Chicago, IL, the Van Mierop Archive at the University of Florida in Gainesville, Florida, and the archive at Johns Hopkins All Children’s Heart Institute in St. Petersburg, Florida, identifying all those exhibiting a vestibular atrial septal defect, along with the associated intracardiac malformations. We then assessed potential mechanisms for the existence of such defects, based on the assessment of 450 datasets of developing mouse hearts prepared using the technique of episcopic microscopy. Results: We analyzed a total of 2100 specimens. Of these, 68 (3%) were found to have a vestibular atrial septal defect. Comparable defects were identified in 10 developing mouse embryos sacrificed at embryonic data 15.5, by which stage the antero-inferior component of the atrial septum is usually normally formed. Conclusion: The vestibular defect is a true septal defect located in the muscular antero-inferior rim of the oval fossa. Our retrospective review of autopsied hearts suggests that the defect may be more common than previously thought. Increased awareness of the location of the defect should optimize its future clinical identification. We suggest that the defect exists because of failure, during embryonic development, of union of the components that bind the leading edge of the primary atrial septum to the atrioventricular junctions, either because of inadequate muscularisation or excessive apoptosis.

How classical are the clinical features of the “ostium secundum” atrial septal defect?

1997 ◽  
Vol 7 (3) ◽  
pp. 294-301 ◽  
Author(s):  
Stefania Tabery ◽  
Otto Daniëls
Keyword(s):  
Atrial Septal Defect ◽  
Clinical Features ◽  
Septal Defect ◽  
Fundamental Problem ◽  
Secundum Atrial Septal Defect ◽  
Large Defect ◽  
X Ray ◽  
Septal Defects ◽  
Functional Defect ◽  
Chest X Ray

AbstractSome patients with so called “secundum” atrial septal defect within the oval fossa show a large defect on the echocardiogram, although they do not have all the classical clinical features. Until now, a large atrial septal defect was thought to be characterized by a large shunt (functional defect). Experience indicates, nonetheless, that such large defects in size (anatomical defect) are not always accompanied by large shunts. In order to assess how often the classical clinical features of an atrial septal defect exist, and to investigate whether the surgical indication for closure of the defect are anatomical or functional, we carried out a retrospective study. We evaluated the records of 161 patients, with birth dates from 1973 to 1994 (age between 0 and 21 years), so as to study the classical clinical features (history, physical examination, electrocardiogram, chest X-ray, echo-Doppler studies, cardiac catheterization, surgery). Only patients with an atrial septal defect found in isolation were included.We discovered that the classical clinical features are often not present when there is a large defect, be it functional or anatomical. The anticipated features are present in roughly two-thirds of the patients. There is also a discrepancy between the anatomical and the functional sizes of the defect. This finding creates a fundamental problem for the future, namely the indications fot closure of atrial septal defects within the oval fossa. Further studies are needed to answer this important question

scholarly journals Catheter-based closure of a large atrial septal defect with inferior rim deficiency using pulmonary vein slide-out assisted implantation technique: a case report

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Salvatore Evola ◽  
Oreste Fabio Triolo ◽  
Giuseppina Novo ◽  
Eustaquio Maria Onorato
Keyword(s):  
Heart Failure ◽  
Atrial Septal Defect ◽  
Pulmonary Vein ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Implantation Technique ◽  
Secundum Atrial Septal Defect ◽  
Septal Defects ◽  
Case Summary ◽  
Implantation Techniques

Abstract Background Transcatheter approach for large and complex atrial septal defects may represent a therapeutic challenge, particularly when the postero-inferior rim is deficient and floppy. Case summary Here, we describe a successful catheter-based closure of a large (>30 mm) secundum atrial septal defect associated with postero-inferior rim deficiency in a 35-year-old female with congestive heart failure using pulmonary vein slide-out assisted implantation technique. Discussion Inferior–posterior rim deficiency is a well-known risk factor for device instability or embolization. Transcatheter closure may represent a safe and effective alternative to the traditional surgical approach provided that modified implantation techniques are employed.

scholarly journals Atrial Septal Defect Presenting as Platypnea Orthodeoxia Syndrome

2018 ◽  
Vol 1 (1) ◽  
pp. 1-2
Author(s):  
Arianne Clare Agdamag ◽  
Joanne Michelle Gomez
Keyword(s):  
Early Intervention ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Symptomatic Improvement ◽  
Upright Position ◽  
Closure Device ◽  
Interatrial Communication ◽  
Arterial Desaturation ◽  
Functional Factor

Platypnea orthodeoxia syndrome (POS) is an uncommon phenomenon characterized by dyspnea and arterial desaturation in an upright position improved with recumbency. It is due to an anatomical factor that allows for interatrial communication and a functional factor that promotes right to left shunting. Once identified, early intervention allows for rapid symptomatic improvement. This case highlights that among patients who present with positional hypoxia, POS should be considered as a possible etiology. Thorough evaluation is warranted to identify potentially reversible etiologies and guide management. Keywords: Platypnea orthodeoxia syndrome, Atrial septal defect, Amplatzer closure device

Pulmonary hypertension in isolated secundum atrial septal defect: High frequency in young patients

1983 ◽  
Vol 105 (6) ◽  
pp. 952-957 ◽  
Author(s):  
George Cherian ◽  
C.Babu Uthaman ◽  
M Durairaj ◽  
I.P Sukumar ◽  
S Krishnaswami ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Atrial Septal Defect ◽  
High Frequency ◽  
Septal Defect ◽  
Young Patients ◽  
Secundum Atrial Septal Defect

Surgical repair of atrial septal defect with severe pulmonary hypertension during pregnancy: a case report with literature review

2012 ◽  
Vol 22 (5) ◽  
pp. 493-498 ◽  
Author(s):  
Suganya Manivannan ◽  
Gul Dadlani ◽  
Michael Parsons ◽  
Luminita Crisan ◽  
Victoria Belogolovkin ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Surgical Repair ◽  
Severe Pulmonary Hypertension ◽  
Secundum Atrial Septal Defect ◽  
Viable Option ◽  
Surgical Closure ◽  
Septal Defects ◽  
Pulmonary Arterial

AbstractWe are reporting a case of a 37-year-old pregnant woman with a large secundum atrial septal defect with left-to-right shunt and severe pulmonary hypertension. Her atrial septal defect was undiagnosed before this pregnancy. After carefully considering all the options, we repaired her atrial septal defect with an open heart surgical closure at 20 weeks of gestation. A substantial and consistent reduction in pulmonary arterial pressure after the surgery and subsequent uneventful delivery indicate that surgical repair of atrial septal defects is a viable option that should be considered for such patients.

Percutaneous Transcatheter Closure of Interatrial Septal Defect in Adults – A Review

2011 ◽  
Vol 6 (2) ◽  
pp. 173
Author(s):  
Joelle Kefer ◽  
Keyword(s):  
Atrial Septal Defect ◽  
Patent Foramen Ovale ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Foramen Ovale ◽  
Secundum Atrial Septal Defect ◽  
Septal Defects ◽  
Device Implantation ◽  
Number Of Patients ◽  
Pfo Closure

Atrial septal abnormalities are common congenital lesions remaining asymptomatic until adulthood in a great number of patients. The most frequent atrial septal defects in adults are ostium secundum atrial septal defect (ASD) and patent foramen ovale (PFO), both approachable by transcatheter closure using device implantation. The article reviews the different devices available, the technique of implantation and the indications for transcatheter ASD and PFO closure.

Robotic, totally endoscopic atrial septal defect repair

2021 ◽  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Early Adulthood ◽  
Small Diameter ◽  
Volume Overload ◽  
Spontaneous Closure ◽  
The Third ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Defect Repair

Atrial septal defect accounts for 10–15% of congenital heart disease cases. Small-diameter atrial septal defects diagnosed during infancy or early adulthood are prone to spontaneous closure, whereas uncorrected, persistent moderate or large atrial septal defects can induce left-to-right shunting, which causes volume overload, heart failure, atrial arrhythmia, and/or pulmonary hypertension starting between the third and fourth decades of life. We describe in detail our technique for totally endoscopic, robotic-assisted atrial septal defect repair.

scholarly journals Tricuspid Regurgitation in Ostium Secundum Atrial Septal Defects: Repair or Not?

2020 ◽  
Vol 23 (2) ◽  
pp. E239-E244 ◽  
Author(s):  
Chirag Sumithra Prasanna Kumar ◽  
Bineesh K Radhakrishnan ◽  
Remya Sudevan ◽  
Jayakumar Karunakaran
Keyword(s):  
Atrial Septal Defect ◽  
Tricuspid Regurgitation ◽  
Septal Defect ◽  
Pulmonary Artery Hypertension ◽  
Tricuspid Valve Repair ◽  
Secundum Atrial Septal Defect ◽  
Atrial Septal Defect Closure ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Functional Tricuspid Regurgitation

Background: Longstanding ostium secundum atrial septal defects lead to functional tricuspid regurgitation. Significant functional tricuspid regurgitation associated with left heart valve disease is addressed at the time of primary left heart valve surgery. In contrast, there is no global recommendation for tricuspid regurgitation associated with atrial septal defects. This study assesses changes in tricuspid regurgitation after isolated atrial septal defect closure. Methods: Retrospectively, records were examined of 100 patients who underwent isolated ostium secundum atrial septal defect closure without tricuspid valve repair. Echocardiograms were done preoperatively and 3 days, 3 months, and 1 year after surgery. Data on tricuspid regurgitation status, right ventricle dimensions, and pulmonary artery hypertension status were collected and analyzed. Results: After surgical closure, echocardiography showed a regression of tricuspid regurgitation to mild or less in 76% of patients at 3 days, 89% at 3 months, and 93% at 1 year. Severe pulmonary artery hypertension (32% patients preoperatively) showed statistically significant regression: 14% at 3 days, 10% at 3 months, and 2% at 1 year. Preoperatively, the mean right ventricular internal diameter was 37.9 mm, which decreased to 34 ± 5.5 mm (mean ± standard deviation) at 3 days, 32.3 ± 5.3 mm at 3 months, and 31.3 ± 5.4 mm at 1 year. It was also noted that regression favored patients who were <25 years old. Conclusion: Tricuspid valve repair may not be required in patients with ostium secundum atrial septal defect with functional tricuspid regurgitation.

Sign in / Sign up

Export Citation Format

Share Document