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Summary
Adult hearts with atrial septal defects often show mitral valve abnormalities. These changes, including cusp thickening and chordae fusion, suggest trauma from abnormal blood flow rather than primary valve disease.
Area of Science:
- Cardiology
- Pathology
- Congenital Heart Disease
Background:
- Secundum atrial septal defects (ASDs) are common congenital heart anomalies.
- Mitral valve abnormalities can occur secondary to hemodynamic changes in ASDs.
Purpose of the Study:
- To investigate the nature and frequency of mitral valve abnormalities in adult hearts with secundum ASDs.
- To differentiate between primary valve pathology and secondary changes due to ASDs.
Main Methods:
- Examination of 16 adult hearts with unclosed secundum ASDs.
- Morphological and histological analysis of the mitral valve apparatus.
Main Results:
- 15 out of 16 hearts exhibited mitral valve abnormalities.
- Consistent findings included thickening of the anterior mitral cusp's medial half and adjacent chordae fusion.
- Histology revealed surface fibrosis without features of rheumatic or floppy valve disease.
Conclusions:
- Mitral valve abnormalities in secundum ASDs are likely secondary to abnormal cusp movement and trauma.
- Hemodynamic alterations and left ventricular geometry changes associated with ASDs contribute to these secondary valve changes.