The treatment of atrial septal defects is essentially surgical. We describe below our experience of the. management of a group of 12 cases.This defect is relatively common. In necropsies on congenital heart cases of all age groups Maude Abbott (1936) found the defect to be the third commonest, and in McGinn and White's series (1936) heart disease showed atrial septal defects to be the second commonest defect between the ages of 5 and 61 years.The sex incidence shows a predominance of female patients (Roesler, 1934;Cosby and Griffith, 1949;Bedford et al., 1941).The morphology of the various types of defect is best understood by a consideration of the embryological development of the septum.The atrial septum is formed by the fusion and overlapping of two septa which eventually divide the single atrium into two cavities. The first, the septum primum, appears at about the fourth week in the roof of the atrium and grows downwards both ventrally and dorsally in the sagittal plane towards the region of the atrioventricular valves and the developing ventricular septum. Growth in its central portion is slower than at the periphery, so that its lower margin becomes crescentic. There is thus left a communication between the two atria which is termed the ostium primum. This foramen then gradually closes, but at the same time the upper part of the septum breaks down to form a second deficiency-the ostium secundum.To the right of the first a second septum now develops, the septum secundum, which grows downwards to overlap the lower edge of this second foramen. The free edge of the second septum forms the annulus ovalis of the fully developed heart. There remains an oblique cleft bounded above by this free edge and, below and to the left, by the lower edge of the foramen secundum through which blood passes during foetal life from the right atrium to the left. Actual fusion of the two septa occurs before the 12th week of extrauterine life in most cases. Seven types of defect may be described (Fig. 1).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.