Surgical Closure of Defects of the Interauricular Septum by Use of an Atrial Well

Gross, Robert E.; Pomeranz, Alfred A.; Watkins, Elton; Goldsmith, Edward I.

doi:10.1056/nejm195209252471301

Cited by 76 publications

(17 citation statements)

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“…Gross et al (1952).-A " well " made of rubber is sutured to the side of the atrium, the atrium opened, and the defect sutured under tactile control. A sheet of plastic material can be sutured over the defect if it is large.…”

Section: Cohnmentioning

confidence: 99%

Surgical Treatment of Atrial Septal Defects

Fr¹,

Hg²,

Jd³

et al. 1955

BMJ

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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).

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Section: Cohnmentioning

confidence: 99%

Surgical Treatment of Atrial Septal Defects

Fr¹,

Hg²,

Jd³

et al. 1955

BMJ

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“…Many ingenious techniques were being evaluated both in the laboratory and in the operating theater, such as the use of a plastic well to enable the surgeon to directly suture inside the heart while it was still beating and supporting circulation. Robert Gross was the first to describe a clinical series of "interauricular septal defects" using this well technique [3]. This experience was reproduced at other centers, opening up the new field of intracardiac surgery.…”

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confidence: 98%

Surgical Innovation: Lessons From the Pragmatic Philosophical School

Nido

2015

The Annals of Thoracic Surgery

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“…7 However, by 1950 it became obvious to those interested in cardiac operations that a heart-lung machine would be required to deal with the majority of congenital cardiac malformations and valvular heart disease.…”

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confidence: 99%