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Primum atrial septal defect

A M Sadeghi1, H Laks, J M Pearl

  • 1Division of Cardiothoracic Surgery, UCLA School of Medicine 90095-1741, USA.

Seminars in Thoracic and Cardiovascular Surgery
|January 1, 1997
PubMed
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Surgical repair of primum atrial septal defect in infants has excellent long-term survival rates. Early diagnosis via echocardiography and timely intervention ensure minimal mortality for this congenital heart defect.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Surgery
  • Echocardiography

Background:

  • Primum atrial septal defect (ASD) is a congenital heart anomaly requiring surgical intervention.
  • Surgical repair has evolved since 1982, with a focus on complete closure of the defect and associated atrioventricular valve clefts.

Purpose of the Study:

  • To review the surgical experience and outcomes of primum atrial septal defect repair.
  • To evaluate the efficacy of current surgical techniques and diagnostic methods.

Main Methods:

  • Surgical repair using a pericardial patch for defect and valve cleft closure.
  • Echocardiography for diagnosis; cardiac catheterization for associated defects.
  • Two-stage repair for coarctation of the aorta and primum ASD.

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Main Results:

  • Low early mortality (<1%) and reoperation rate (<3%).
  • Excellent long-term survival comparable to the general population.
  • Successful management of severe congestive heart failure and left atrioventricular valve regurgitation.

Conclusions:

  • Echocardiography is the primary diagnostic tool; catheterization reserved for complex cases.
  • Early repair in stable patients (<2-3 years) yields minimal mortality.
  • Associated coarctation of the aorta requires staged repair; long-term outcomes are excellent.