[A new surgical method for the creation of atrial septal defects]

For the creation of atrial septal defect (ASD), we have developed a new method (Method I) using modified Harken blade for the closed commissurotomy, in which the membranous septum of the fossa ovalis was incised in case of patent foramen ovale (PFO). When there was no or very narrow PFO, we applied Schuster's procedure to create defect in the muscular and membranous septum, however, it was sometimes found the bridging of remnant of membranous septum was left. So that, we have applied the Method I to cut it off (Method II). Up to date, eleven patients were operated with the Method I, and three patients with the Method II. As the results, nearly no pressure gradient between right and left atrium was detected postoperatively. In two cases, sufficiently created ASDs were confirmed at radical surgery. Because of the safety and reliability, our new procedures appear to be more advantageous in comparing to conventional Blalock-Hanlon or other procedures.