Radiologic and echocardiographic patterns of 98 cases of atrial septal defect without other defects (isolated atrial...

We collected 98 cases of single atrial septal defect. Analytical study of the pulmonary vasculature and the shape of the heart allowed us to differentiate 71 cases of pulmonary hypervascularity with increased cardiothoracic index and an appearance of right ventricular dilatation. The left inferior segment was usually straight, but sometimes convex, with a great curvature including the middle left segment. Apart from these 71 typical cases, there were 18 cases of incomplete patterns, 7 cases of atypical patterns with a convex left inferior segment with a small curvature and two normal cases (normal shape of the heart and normal vasculature). - Echocardiography was performed in 35 cases. It was valuable in 34 cases and established the diagnosis each time the X-ray picture was uncertain. Increase of the ratio of the telediastolic diameter of the right to left ventricle is almost constant and the septal motion is paradoxical in 79% of all cases. - Post-operative change was characterized from the radiological point of view by rapid return to normal of the pulmonary vascularity, followed by decrease of the cardiothoracic index, while the modifications of the shape of the left middle and inferior segment regress slowly and incompletely. As for echocardiography there is constant decrease of the ratio of the telediastolic diameter of the right to left ventricle, while the septal motion returns to normal in 79% of all cases.