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Cardiology Clinics Aug 2020Atrial septal defects are common congenital heart defects, characterized by insufficient/absent tissue at the interatrial septum. An unrepaired defect may be associated... (Review)
Review
Atrial septal defects are common congenital heart defects, characterized by insufficient/absent tissue at the interatrial septum. An unrepaired defect may be associated with right heart volume overload, atrial arrhythmia or pulmonary arterial hypertension. The 3 major types of atrial septal defect are: ostium secundum defect, ostium primum defect, and sinus venosus. Characteristic physical findings include a midsystolic pulmonary flow or ejection murmur, accompanied by a fixed split-second heart sound. Small defects may spontaneously close; larger defects may persist and result in hemodynamic and clinical sequelae requiring percutaneous or surgical intervention. Severe pulmonary arterial hypertension is a contraindication to closure.
Topics: Conservative Treatment; Heart Septal Defects, Atrial; Hemodynamics; Humans; Patient Selection; Surgical Procedures, Operative; Symptom Assessment
PubMed: 32622487
DOI: 10.1016/j.ccl.2020.04.001 -
European Heart Journal Jul 2022Atrial septal defects (ASDs) represent the most common congenital heart defect diagnosed in adulthood. Although considered a simple defect, challenges in optimal... (Review)
Review
Atrial septal defects (ASDs) represent the most common congenital heart defect diagnosed in adulthood. Although considered a simple defect, challenges in optimal diagnostic and treatment options still exist due to great heterogeneity in terms of anatomy and time-related complications primarily arrhythmias, thromboembolism, right heart failure and, in a subset of patients, pulmonary arterial hypertension (PAH). Atrial septal defects call for tertiary expertise where all options may be considered, namely catheter vs. surgical closure, consideration of pre-closure ablation for patients with atrial tachycardia and suitability for closure or/and targeted therapy for patients with PAH. This review serves to update the clinician on the latest evidence, the nuances of optimal diagnostics, treatment options, and long-term follow-up care for patients with an ASD.
Topics: Adult; Arrhythmias, Cardiac; Cardiac Catheterization; Heart Septal Defects, Atrial; Humans; Pulmonary Arterial Hypertension; Treatment Outcome
PubMed: 34535989
DOI: 10.1093/eurheartj/ehab646 -
Echocardiography (Mount Kisco, N.Y.) Dec 2020Atrial septal defects (ASD) are among the most common congenital heart diseases encountered in adulthood. Patent foramen ovale (PFO) is present in up to 25% of the... (Review)
Review
Atrial septal defects (ASD) are among the most common congenital heart diseases encountered in adulthood. Patent foramen ovale (PFO) is present in up to 25% of the population. ASD could present as isolated lesion or in association with more complex congenital heart disease form as tetralogy of Fallot, or Ebstein's anomaly of tricuspid valve. There is a wide range of clinical presentation ranging from asymptomatic subjects surviving to adulthood undiagnosed to subjects presenting with right heart failure and severe pulmonary vascular disease (Eisenmenger syndrome). This manuscript is an in depth review of the complex atrial septation, the variable clinical presentation of ASD and PFO, and its clinical and therapeutic implications.
Topics: Adult; Foramen Ovale, Patent; Heart Septal Defects, Atrial; Humans
PubMed: 33368546
DOI: 10.1111/echo.14646 -
Seminars in Roentgenology Jul 1985
Review
Topics: Angiography; Child; Echocardiography; Eisenmenger Complex; Heart Aneurysm; Heart Septal Defects, Atrial; Humans; Hypertension, Pulmonary; Male; Middle Aged; Mitral Valve Insufficiency; Mitral Valve Prolapse; Radionuclide Imaging
PubMed: 3898390
DOI: 10.1016/0037-198x(85)90005-7 -
Cardiology 2019
Topics: Cardiac Catheterization; Echocardiography, Transesophageal; Heart Septal Defects, Atrial; Humans; Septal Occluder Device
PubMed: 31117079
DOI: 10.1159/000496348 -
JACC. Cardiovascular Interventions Mar 2021
Topics: Heart Septal Defects, Atrial; Humans; Septal Occluder Device; Treatment Outcome
PubMed: 33663786
DOI: 10.1016/j.jcin.2021.01.008 -
Seminars in Thoracic and Cardiovascular... Jan 1997The purpose of this report is to review our surgical experience with primum atrial septal defect. Since 1982, infants with primum atrial septal defect have undergone... (Review)
Review
UNLABELLED
The purpose of this report is to review our surgical experience with primum atrial septal defect. Since 1982, infants with primum atrial septal defect have undergone complete repair consisting of closure of the cleft of the left atrioventricular valve and atrial septal defect with a pericardial patch. Ages at operation ranged from early neonatal period until 5 years. In most patients, echocardiography was diagnostic and cardiac catheterization was performed in children with associated defects. Severe congestive heart failure and left atrioventricular valve regurgitation necessitated earlier correction. Infants with coarctation of the aorta and primum atrial septal defect underwent a two-stage procedure involving coarctation resection followed by complete repair. The early mortality rate is less than 1% and has a reoperation rate of less than 3%. The overall long-term survival of patients with primum atrial septal defect matches that of the general population.
CONCLUSION
The diagnosis of primum atrial septal defect can easily be made by echocardiography with cardiac catheterization reserved for patients with associated left-sided obstruction. For patients in stable condition, the total repair can be performed before 2 to 3 years of age with minimum mortality. In infants with severe congestive heart failure, earlier correction should be contemplated, although it carries a higher morbidity. The associated coarctation of aorta is infrequent, but requires resection before intracardiac repair. The long-term results with this lesion repair are excellent.
Topics: Aortic Coarctation; Cardiac Catheterization; Cardiopulmonary Bypass; Child, Preschool; Echocardiography; Endocardial Cushion Defects; Heart Septal Defects, Atrial; Heart Ventricles; Humans; Hypoplastic Left Heart Syndrome; Infant; Suture Techniques; Tricuspid Valve
PubMed: 9109219
DOI: No ID Found -
JACC. Cardiovascular Interventions Sep 2020
Topics: Heart Septal Defects, Atrial; Humans; Hypertension, Pulmonary; Septal Occluder Device; Treatment Outcome
PubMed: 32800499
DOI: 10.1016/j.jcin.2020.05.023 -
Internal Medicine (Tokyo, Japan) Jan 2022
Topics: Cardiac Catheterization; Echocardiography, Transesophageal; Heart Septal Defects, Atrial; Humans; Prosthesis Design; Septal Occluder Device; Treatment Outcome
PubMed: 33583908
DOI: 10.2169/internalmedicine.6946-20 -
Catheterization and Cardiovascular... Jun 2021With an increase in number of patients undergoing percutaneous treatment of severe mitral regurgitation with MitraClip placement, the consequences of transseptal...
With an increase in number of patients undergoing percutaneous treatment of severe mitral regurgitation with MitraClip placement, the consequences of transseptal puncture resulting in iatrogenic atrial septal defects (iASDs) are being increasingly realized. Closure of iASDs following MitraClip therapy is not routinely performed, and no guidelines currently exist in managing this condition. While immediate hemodynamic and clinical compromise secondary to acute hypoxemia related to iASDs should be acutely managed with defect closure, the prevalence and consequences of long-term iASDs are still unclear. Some studies have cited a potential improvement in hemodynamic outcomes as a result of iASDs; while others report potential inferior and even fatal outcomes. In this state-of-the-art clinical review, we present the readers with the current data on the prevalence, outcomes, and potential management options of iASDs after MitraClip placement.
Topics: Cardiac Catheterization; Heart Septal Defects, Atrial; Hemodynamics; Humans; Iatrogenic Disease; Mitral Valve Insufficiency; Treatment Outcome
PubMed: 32710470
DOI: 10.1002/ccd.29149