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Morphogenetic differences of secundum atrial septal defects
N A Blom1, J Ottenkamp, T H Jongeneel
1Department of Pediatric Cardiology, Leiden University Medical Center, P.O. Box 9602, The Netherlands.
Pediatric Cardiology
|December 24, 2005
Summary
Secundum atrial septal defects (ASDII) arise from varied causes, not solely septum primum resorption. Both septum primum and septum secundum defects contribute to ASDII, impacting genetic research and patient differentiation.
Area of Science:
- Embryology
- Cardiovascular Anatomy
- Congenital Heart Defects
Background:
- Secundum atrial septal defect (ASDII) is commonly attributed to excessive resorption of the atrial septum primum.
- This traditional view may not fully account for all observed cases of ASDII.
Purpose of the Study:
- To investigate the diverse developmental origins of secundum atrial septal defects (ASDII).
- To differentiate between septum primum and septum secundum contributions to ASDII.
- To inform genetic studies by characterizing ASDII morphogenesis.
Main Methods:
- Postmortem examination of 58 hearts with ASDII and 22 normal hearts.
- Detailed analysis of the anatomical structures of the oval fossa.
- Classification of ASDII based on septum primum malformations.
Main Results:
- 86% of ASDII cases resulted from malformations of the valvula foraminis ovalis or atrial septum primum.
- 14% of ASDII cases were caused by an absent superior limbus (septum secundum).
- ASDII related to septum primum defects were subcategorized by deficiency and ostium secundum position.
Conclusions:
- The morphogenesis of ASDII is variable, involving defects in both the septum primum and septum secundum.
- Understanding these varied origins is crucial for genetic studies and precise patient stratification.
- This research highlights the complexity of ASDII development beyond septum primum resorption.