Document Detail

Factors associated with development of atrial septal restriction in patients with tricuspid atresia involving the right-sided atrioventricular valve.
MedLine Citation:
PMID:  18035100     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Clinical practice is discrepant regarding routine enlargement of the interatrial communication (IAC) in patients with right-sided atrioventricular valve atresia. We determined the percentage and risk factors of those who develop a restrictive IAC. METHODS: Medical records were reviewed for patients treated from 1985 to 2006, including those admitted in the first 6 weeks of life (group A), and those referred at a later age (group B), some of whom had routine atrial septal procedures. In group A, we analyzed the initial postnatal echocardiogram. RESULTS: Group A consisted of 79 patients, 16 of whom had an atrial septectomy as part of the initial surgical procedure. Of the remaining 63 patients, 9 (14%) developed atrial septal restriction. In group A, an atrial septal aneurysm (ASA) (OR 16, P = .006) and IAC diameter < 5 mm (OR 13, P = .009) were associated with atrial septal restriction. Atrial septal restriction occurred in 80% of patients with both features, 20% with IAC > or = 5 mm and ASA, 18% with IAC < 5 mm and no ASA, and 2% with neither feature. Group B consisted of 95 patients, 27 of whom had an atrial septal procedure. Of the remaining 68 patients, 11 (16%) developed atrial septal restriction. CONCLUSION: Routine enlargement of the IAC is not necessary in patients with right-sided atrioventricular valve atresia. Patients with ASA or IAC < 5 mm are at increased risk for development of atrial septal restriction.
Aphrodite Tzifa; Kimberlee Gauvreau; Robert L Geggel
Publication Detail:
Type:  Journal Article     Date:  2007-10-01
Journal Detail:
Title:  American heart journal     Volume:  154     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-23     Completed Date:  2007-12-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1235-41     Citation Subset:  AIM; IM    
Department of Cardiology, Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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MeSH Terms
Atrial Septum / pathology,  surgery
Child, Preschool
Follow-Up Studies
Foramen Ovale, Patent / pathology*,  surgery,  ultrasonography
Infant, Newborn
Risk Factors
Tricuspid Atresia* / physiopathology,  ultrasonography

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