Cardiovascular System - Atrial Septal Defects
Embryology - 23 May 2024 Expand to Translate |
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LB20 Congenital Anomaly of Atrioventricular Valves or Septum
ICD-11 Structural developmental anomalies of the circulatory system (draft) |
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ICD-11 Beta Draft - NOT FINAL, updated on a daily basis, It is not approved by WHO, NOT TO BE USED for CODING except for agreed FIELD TRIALS.
20 Developmental Anomalies - Structural Developmental Anomalies Beta coding and tree structure for "structural developmental anomalies" within this section are shown in the table below. |
Structural developmental anomalies of the circulatory system |
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CD-11 Beta Draft - NOT FINAL, updated on a daily basis, It is not approved by WHO, NOT TO BE USED for CODING except for agreed FIELD TRIALS.
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Introduction
International Classification of Diseases (ICD-10) - Q21 Congenital malformations of cardiac septa Q21.1 Atrial septal defect Coronary sinus defect Patent or persistent: foramen ovale ostium secundum defect (type II) Sinus venosus defect
Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomolies defects occuring in a number of different forms and more often in females.
- patent foramen ovale- allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bepassed from one atria to the other) exists.
- ostium secundum defect
- endocardial cushion defect involving ostium primum
- sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
- common atrium
Some Recent Findings
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More recent papers |
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This table allows an automated computer search of the external PubMed database using the listed "Search term" text link.
More? References | Discussion Page | Journal Searches | 2019 References | 2020 References Search term: Atrial Septal Defect <pubmed limit=5>Atrial Septal Defect</pubmed> |
Movies
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Oval Fossa Defect
The cross-section of a human heart shows defects (patent foramen ovale) in the floor of the oval fossa (fossa ovalis, annulus ovalis) shown by double headed white arrow due to deficiency and perforation of the flap valve derived from the primary atrial septum. The white arrow with black borders shows the intact infolded cranial rim of the fossa. |
Human heart has been sectioned across the short axis of the atrial chambers, and photographed from above, to show a persistently patent oval foramen (double headed red arrow). The double headed white arrow shows the normal rims of the oval fossa, which are overlapped by the flap valve, but in absence of fusion with the left atrial aspect of the rims. |
Heart specimen images produced by Diane Spicer. |
Sinus Venosus Atrial Septal Defect
Sinus venosus atrial septal defects (SV-ASDs) are inter-atrial abnormality caused by a deficiency of the common wall between the superior or inferior vena cava and the right-sided pulmonary veins. The images below are MRI from a 25-year-old asymptomatic male[2] SSFP - Breath-held fat suppressed three-dimensional steady-state free precession.
MRI SSFP sagittal view | SSFP axial view |
Turbo spin-echo axial plane | SSFP dilated right ventricle |
- Links: Magnetic Resonance Imaging
History
1941
ATRIAL SEPTAL DEFECT.[3]
- "Patent foramen ovale and atrial (or auricular) septal defect (A.S.D.), though both characterised by an aperture in the atrial septum, are embryologically and pathologically different conditions."
Treatment
The surgical repair requires a cardiopulmonary bypass and is recommended in most cases of ostium secundum ASD, even though there is a significant risk involved. Ostium primum defects tend to present earlier and are often associated with endocardial cushion defects and defective mitral or tricuspid valves. In such cases, valve replacement may be necessary and the extended operation has a considerable chance of mortality.
- Increasingly closure by a transcatheter device closure has been applied.
- Repair of atrial septal defects on the perfused beating heart (atrial septal defect size 2 cm - 4.5 cm) [4]
International Classification of Diseases
The International Classification of Diseases (ICD) World Health Organization's classification used worldwide as the standard diagnostic tool for epidemiology, health management and clinical purposes. This includes the analysis of the general health situation of population groups. It is used to monitor the incidence and prevalence of diseases and other health problems.
The ICD-10 classification system is being updated in 2017 to ICD-11 (currently in draft release).
ICD-11 Structural developmental anomalies of the circulatory system (draft) |
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ICD-11 Beta Draft - NOT FINAL, updated on a daily basis, It is not approved by WHO, NOT TO BE USED for CODING except for agreed FIELD TRIALS.
20 Developmental Anomalies - Structural Developmental Anomalies Beta coding and tree structure for "structural developmental anomalies" within this section are shown in the table below. |
Structural developmental anomalies of the circulatory system |
|
CD-11 Beta Draft - NOT FINAL, updated on a daily basis, It is not approved by WHO, NOT TO BE USED for CODING except for agreed FIELD TRIALS.
|
Within the ICD-10 classification "congenital malformations, deformations and chromosomal abnormalities" are (Q00-Q99) but excludes "inborn errors of metabolism" (E70-E90).
Congenital malformations of the circulatory system (Q20-Q28)
- ICD-10 Code: Q21.1 Atrial septal defect
Q21 Congenital malformations of cardiac septa
Excl.: acquired cardiac septal defect (I51.0)
- Q21.0 Ventricular septal defect
- Q21.1 Atrial septal defect Coronary sinus defect Patent or persistent: foramen ovale ostium secundum defect (type II) Sinus venosus defect
- Q21.2 Atrioventricular septal defect Common atrioventricular canal Endocardial cushion defect Ostium primum atrial septal defect (type I)
- Q21.3 Tetralogy of Fallot Ventricular septal defect with pulmonary stenosis or atresia, dextroposition of aorta and hypertrophy of right ventricle.
- Q21.4 Aortopulmonary septal defect Aortic septal defect Aortopulmonary window
- Q21.8 Other congenital malformations of cardiac septa Eisenmenger's defect Pentalogy of Fallot Excl.: Eisenmenger's complex (I27.8) syndrome (I27.8)
- Q21.9 Congenital malformation of cardiac septum, unspecified Septal (heart) defect NOS
Cardiovascular Abnormalities
Heart defects and preterm birth are the most common causes of neonatal and infant death. The long-term development of the heart combined with extensive remodelling and post-natal changes in circulation lead to an abundance of abnormalities associated with this system.
A UK study literature showed that preterm infants have more than twice as many cardiovascular malformations (5.1 / 1000 term infants and 12.5 / 1000 preterm infants) as do infants born at term and that 16% of all infants with cardiovascular malformations are preterm. (0.4% of live births occur at greater than 28 weeks of gestation, 0.9% at 28 to 31 weeks, and 6% at 32 to 36 weeks. Overall, 7.3% of live-born infants are preterm)[5]
"Baltimore-Washington Infant Study data on live-born cases and controls (1981-1989) was reanalyzed for potential environmental and genetic risk-factor associations in complete atrioventricular septal defects AVSD (n = 213), with separate comparisons to the atrial (n = 75) and the ventricular (n = 32) forms of partial AVSD. ...Maternal diabetes constituted a potentially preventable risk factor for the most severe, complete form of AVSD." [6]
In addition, there are in several congenital abnormalities that exist in adults (bicuspid aortic valve, mitral valve prolapse, and partial anomalous pulmonary venous connection) which may not be clinically recognized.
References
Articles
<pubmed>22252195</pubmed> <pubmed>22219470</pubmed> <pubmed>22097699</pubmed> <pubmed>22066780</pubmed> <pubmed>21545985</pubmed>
Search Pubmed
Search Pubmed: Atrial Septal Defect
External Links
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- OMIM Atrial Septal Defect
- Medline Plus ASD Repair Video
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Cite this page: Hill, M.A. (2024, May 23) Embryology Cardiovascular System - Atrial Septal Defects. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Cardiovascular_System_-_Atrial_Septal_Defects
- © Dr Mark Hill 2024, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G