Project description:BackgroundSurgical and perioperative improvements permit earlier repair of partial and transitional atrioventricular septal defects (AVSD). We sought to describe contemporary outcomes in a multicenter cohort.MethodsWe studied 87 patients undergoing primary biventricular repair of partial or transitional AVSD between June 2004 and February 2006 across seven North American centers. One-month and 6-month postoperative data included weight-for-age z-scores, left atrioventricular valve regurgitation (LAVVR) grade, residual shunts, and left ventricular ejection fraction. Paired methods were used to assess 6-month change.ResultsMedian age at surgery was 1.8 years; median weight z-score was -0.88. Median days for ventilation were 1, intensive care 2, and hospitalization 5, all independent of age, with 1 in-hospital death. At 1 month, 27% (16 of 73) had ejection fraction less than 55%; 20% (17 of 87) had significant LAVVR; 2 had residual shunts; 1 each had subaortic stenosis and LAVV stenosis. At 6 months (n = 60), there were no interim deaths, reinterventions, or new development of subaortic or LAVV stenosis. Weight z-score improved by a median 0.4 units (p < 0.001), especially for underweight children less than 18 months old. Left atrioventricular valve regurgitation occurred in 31% (change from baseline, p = 0.13), occurring more frequently in patients repaired at 4 to 7 years (p = 0.01). Three patients had ejection fraction less than 55%, and 1 had a residual atrial shunt.ConclusionsSurgical repair for partial/transitional AVSD is associated with low morbidity and mortality, short hospital stays, and catch-up growth, particularly in underweight children repaired between 3 and 18 months of age. Left atrioventricular valve regurgitation remains the most common residual defect, occurring more frequently in children repaired after 4 years of age.

| S-EPMC2900854 | biostudies-literature

Transesophageal echocardiography in an atrioventricular septal defect.

Project description: Not available

| S-EPMC5070315 | biostudies-literature

Clinical Features and Outcomes in Adults With Childhood Repair of Partial Atrioventricular Septal Defect

Project description: Not available

| S-EPMC11198577 | biostudies-literature

Giant pulmonary artery aneurysm secondary to primary pulmonary hypertension.

Project description: Not available

| S-EPMC2851441 | biostudies-literature

Large Atrial Septal Aneurysm Associated with Secundum Atrial Septal Defect.

Project description: Not available

| S-EPMC9270672 | biostudies-literature

Atrial septal defect with pulmonary hypertension: when/how can we consider closure?

Project description:Patients having atrial septal defect (ASD) with moderate and more importantly severe pulmonary arterial hypertension (PAH) pose a clinical dilemma. Closing ASD in those with irreversible PAH and not closing it when the PAH is reversible can cost patients dearly, both in terms of quality of life and longevity. In our experience, there is no single parameter that can help in decision making in this difficult subset of patients and therefore we recommend a multi-dimensional approach, which takes into consideration clinical, radiological, electrocardiographic and hemodynamic variables as a whole. ASD with restrictive left ventricular (LV) physiology can lead to pulmonary venous hypertension, which can manifest as life threatening acute pulmonary edema following device closure. All high-risk candidates prone to having this combination should be prepared with diuretics and vasodilators prior to bringing them to catheterization laboratory and should be assessed with temporary balloon/device occlusion prior to permanent closure of the defect. In those cases of ASD with borderline operability either due to severe PAH or LV restrictive physiology, perforated device may be helpful in preventing acute or long-term complications of complete closure.

| S-EPMC6174154 | biostudies-other

Pulmonary hypertension, hemoptysis and an echocardiographic finding of a ventricular septal defect.

Project description: Not available

| S-EPMC3555573 | biostudies-literature

Clinics in diagnostic imaging (186). Atrial septal defect with pulmonary arterial hypertension.

Project description:We report a case of a 61-year-old woman with a large atrial septal defect (ASD) that was detected incidentally on chest radiography and computed tomography when she presented with sepsis. Echocardiography confirmed a large secundum ASD with left-to-right shunt flow, right heart dilatation and severe pulmonary hypertension. The patient had a poor clinical outcome despite intensive care and eventually passed away. Haemodynamically significant ASDs have a known association with increased morbidity and mortality, and their early detection and closure cannot be understated. This article aimed to highlight the imaging features of ASD, with special emphasis on the routine chest radiograph. The pathophysiology and clinical manifestations of ASD are also briefly discussed.

| S-EPMC5966638 | biostudies-literature

A Positive Microbubble Study in Ventricular Septal Defect Patient Without Pulmonary Hypertension.

Project description:A stroke patient with supracristal ventricular septal defect accompanying suspected patent foramen ovale underwent transthoracic and transesophageal echocardiography with agitated saline microbubble study, a positive trans-ventricular microbubble jet after Valsalva maneuver provocation was detected, indicating instantaneous transient paradoxical right-to-left shunt at late diastole might be the etiology of embolic events. (Level of Difficulty: Intermediate.).

| S-EPMC10107004 | biostudies-literature

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