Surgical Correction of Posttraumatic Ventricular Septal Defect via the Right Atrium

AbstractWe describe a neonate who presented with an echogenic mass in the right atrium 8 weeks after closure of ventricular and atrial septal defects. On a routine post operative check up after discharge, a mass was detected in the right atrium on echocardiography. As a thrombotic formation was suggested, lysis was started, in combination with the administration of unfractioned heparin. As there was no change in echogenicity or size of the mass, it was surgically excised. Histopathological examination revealed a myofibroblastic inflammatory tumour.

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The Gerbode Defect: The Significance of a Left Ventricular to Right Atrial Shunt

Cardiology in the Young ◽

10.1017/s1047951109991685 ◽

2009 ◽

Vol 19 (S2) ◽

pp. 96-99 ◽

Cited By ~ 24

Author(s):

Angela M. Kelle ◽

Luciana Young ◽

Sunjay Kaushal ◽

C. Elise Duffy ◽

Robert H. Anderson ◽

...

Keyword(s):

Ventricular Septal Defect ◽

Tricuspid Valve ◽

Right Atrium ◽

Septal Defect ◽

Left Ventricular ◽

Right Atrial ◽

Surgical Closure ◽

The Mean ◽

The Right ◽

Membranous Septum

AbstractBackgroundThe so-called Gerbode ventriculo-atrial defect is a rare defect that permits shunting from the left ventricle to the right atrium. It takes 2 forms, either a deficiency of the atrioventricular membranous septum, or shunting initially through a ventricular septal defect, with atrial shunting occurring through a deficiency in the septal leaflet of the tricuspid valve. In this review, we describe the natural history and outcomes of surgical repair for the variant with shunting through a deficiency at the site of the atrioventricular membranous septum.MethodsFrom 1990 to 2008, we identified 6 patients from our departmental database who had undergone surgical closure of a congenital defect of the atrioventricular component of the membranous septum. Median age at repair was 1.6 years, with a range, from 0.4 to 19 years. All patients were symptomatic, with 3 having congestive cardiac failure, 2 failing to thrive, and 2 having intolerance to exercise. All had a dilated right atrium demonstrated by echocardiogram, with a mean preoperative gradient measured by echocardiogram to be 109 millimetres of mercury, with a range from 65 to 150 millimetres of mercury.ResultsThere was no operative or late mortality. The mean size of the defect was 6.2 ± 2.0 millimetres, with a range from 4 to 8 millimetres. All were closed by insertion of a patch. The mean period of cardiopulmonary bypass was 90.5 ± 11.3 minutes, the mean time of aortic cross-clamping 54.8 ± 6.9 minutes, and the mean length of stay in hospital 4.3 ± 1.0 days. No patient had a residual defect, and only trivial regurgitation of the tricuspid valve was evident by postoperative echocardiography. There were no complications or reoperations.ConclusionThe membranous ventriculo-atrial defect can be recognized echocardiographically on the basis of dilation of the right atrium in the setting of an unusually high Doppler echocardiogram gradient compared to the ventricular septal defect with shunting only at ventricular level. Since all patients in our series were symptomatic, we recommend surgical closure of all these defects.

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Closure of Secundum Atrial Septal Defect with Autologous Right Atrial Patch: Case Report

The Heart Surgery Forum ◽

10.1532/hsf98.20041173 ◽

2005 ◽

Vol 8 (2) ◽

pp. 96 ◽

Cited By ~ 1

Author(s):

Osman Tansel Dar�in ◽

Alper Sami Kunt ◽

Mehmet Halit Andac

Keyword(s):

Atrial Septal Defect ◽

Right Atrium ◽

Septal Defect ◽

Complete Recovery ◽

Interatrial Septum ◽

Right Atrial ◽

Atrial Wall ◽

Residual Shunt ◽

Asd Closure ◽

The Right

Background: Although various synthetic materials and pericardium have been used for atrial septal defect (ASD) closure, investigators are continuing to search for an ideal material for this procedure. We report and evaluate a case in which autologous right atrial wall tissue was used for ASD closure. Case: In this case, we closed a secundum ASD of a 22-year-old woman who also had right atrial enlargement due to the defect. After establishing standard bicaval cannulation and total cardiopulmonary bypass, we opened the right atrium with an oblique incision in a superior position to a standard incision. After examining the secundum ASD, we created a flap on the inferior rim of the atrial wall. A stay suture was stitched between the tip of the flap and the superior rim of the defect, and suturing was continued in a clockwise direction thereafter. Considering the size and shape of the defect, we incised the inferior attachment of the flap, and suturing was completed. Remnants of the flap on the inferior rim were resected, and the right atrium was closed in a similar fashion. Results: During an echocardiographic examination, neither a residual shunt nor perigraft thrombosis was seen on the interatrial septum. The patient was discharged with complete recovery. Conclusion: Autologous right atrial patch is an ideal material for ASD closure, especially in patients having a large right atrium. A complete coaptation was achieved because of the muscular nature of the right atrial tissue and its thickness, which is a closer match to the atrial septum than other materials.

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A Rare Anatomic Variation: A Combination of Anomalous Origin of the Right Subclavian Artery from the Main Pulmonary Artery, Ventricular Septal Defect, and Aortic Coarctation

The Heart Surgery Forum ◽

10.1532/hsf98.20091172 ◽

2010 ◽

Vol 13 (3) ◽

pp. E202-E204 ◽

Cited By ~ 1

Author(s):

Can Vuran ◽

Oguz Omay ◽

Canan Ayabakan ◽

Ozgen Ilgaz Kocyigit ◽

Uygar Yoruker ◽

...

Keyword(s):

Ventricular Septal Defect ◽

Pulmonary Artery ◽

Subclavian Artery ◽

Aortic Coarctation ◽

Septal Defect ◽

Anatomic Variation ◽

Main Pulmonary Artery ◽

Anomalous Origin ◽

The Right

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Effect of breast milk oral care in infants who underwent surgical correction of ventricular septal defect

Cardiology in the Young ◽

10.1017/s1047951121001438 ◽

2021 ◽

pp. 1-4

Author(s):

Xian-Rong Yu ◽

Yu-Qing Lei ◽

Jian-Feng Liu ◽

Zeng-Chun Wang ◽

Hua Cao ◽

...

Keyword(s):

Breast Milk ◽

Ventricular Septal Defect ◽

Septal Defect ◽

Oral Care ◽

Intervention Group ◽

Physiological Saline ◽

Surgical Correction ◽

Controlled Study ◽

Care Group ◽

Control Group

Abstract Objective: This study explored the clinical effect of employing breast milk oral care for infants who underwent surgical correction of ventricular septal defect. Methods: A prospective randomised controlled study was conducted in a provincial hospital between January, 2020 and July, 2020 in China. Patients were randomly divided into an intervention group (breast milk oral care, n = 28) and a control group (physiological saline oral care, n = 28). The intervention group was given oral nursing using breast milk for infants in the early post-operative period, and the control group was given oral nursing using physiological saline. Related clinical data were recorded and analysed. Results: There were no significant differences in age, gender, weight, operation time, cardiopulmonary bypass time, or aortic cross-clamping time between the two groups. Compared with the physiological saline oral care group, the mechanical ventilation duration, the length of ICU stay in the breast milk oral care group were significantly shorter. The time of start feeding and total enteral nutrition were significantly earlier in the intervention group than those in the control group. The incidence of post-operative pneumonia in the breast milk oral care group was 3.6%, which was significantly lower than that of the physiological saline oral care group. Conclusion: The use of breast milk for oral care in infants who underwent surgical correction of VSD can reduce the incidence of post-operative pneumonia and promote the recovery of gastrointestinal function.

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P649 Before and after: sinus venosus atrial septal defect

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.331 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

I Marco Clement ◽

R Eiros ◽

R Dalmau ◽

T Lopez ◽

G Guzman ◽

...

Keyword(s):

Atrial Septal Defect ◽

Left Atrium ◽

Atrial Flutter ◽

Superior Vena Cava ◽

Right Atrium ◽

Septal Defect ◽

Superior Vena ◽

Pulmonary Veins ◽

Vena Cava ◽

The Right

Abstract Introduction The diagnosis of sinus venosus atrial septal defect (SVASD) is complex and requires special imaging. Surgery is the conventional treatment; however, transcatheter repair may become an attractive option. Case report A 60 year-old woman was admitted to the cardiology department with several episodes of paroxysmal atrial flutter, atrial fibrillation and atrioventricular nodal reentrant tachycardia. She reported a 10-year history of occasional palpitations which had not been studied. A transthoracic echocardiography revealed severe right ventricle dilatation and moderate dysfunction. Right volume overload appeared to be secondary to a superior SVASD with partial anomalous pulmonary venous drainage. A transesophageal echocardiography confirmed the diagnosis revealing a large SVASD of 16x12 mm (Figure A) with left-right shunt (Qp/Qs 2,2) and two right pulmonary veins draining into the right superior vena cava. Additionally, it demonstrated coronary sinus dilatation secondary to persistent left superior vena cava. CMR and cardiac CT showed right superior and middle pulmonary veins draining into the right superior vena cava 18 mm above the septal defect (Figures B and C). After discussion in clinical session, a percutaneous approach was planned to correct the septal defect and anomalous pulmonary drainage. For this purpose, anatomical data obtained from CMR and CT was needed to plan the procedure. During the intervention two stents graft were deployed in the right superior vena cava. The distal stent was flared at the septal defect level so as to occlude it while redirecting the anomalous pulmonary venous flow to the left atrium (Figure D). Control CT confirmed the complete occlusion of the SVASD without residual communication from pulmonary veins to the right superior vena cava or the right atrium (Figure E). Anomalous right superior and middle pulmonary veins drained into the left atrium below the stents. Transthoracic echocardiographies showed progressive reduction of right atrium and ventricle dilatation. The patient also underwent successful ablation of atrial flutter and intranodal tachycardia. She is currently asymptomatic, without dyspnea or arrhythmic recurrences. Conclusions In this case, multimodality imaging played a key role in every stage of the clinical process. First, it provided the diagnosis and enabled an accurate understanding of the patient’s anatomy, particularly of the anomalous pulmonary venous connections. Secondly, it allowed a transcatheter approach by supplying essential information to guide the procedure. Finally, it assessed the effectiveness of the intervention and the improvement in cardiac hemodynamics during follow-up. Abstract P649 Figure.

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