Talk:Cardiovascular System - Atrial Septal Defects
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Cite this page: Hill, M.A. (2019, August 18) Embryology Cardiovascular System - Atrial Septal Defects. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Cardiovascular_System_-_Atrial_Septal_Defects
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Atrial Septal Defect
<pubmed limit=5>Atrial Septal Defect</pubmed>
Atrial Septal Defect Development
<pubmed limit=5>Atrial Septal Defect Development</pubmed>
Three-dimensional echocardiographic assessment of atrial septal defects
Ann Card Anaesth. 2015 Jan-Mar;18(1):69-73. doi: 10.4103/0971-9784.148324.
German C, Nanda NC1.
Echocardiography provides a useful tool in the diagnosis of many congenital heart diseases, including atrial septal defects, and aids in further delineating treatment options. Although two-dimensional echocardiography has been the standard of care in this regard, technological advancements have made three-dimensional echocardiography possible, and the images obtained in this new imaging modality are able to accurately portray the morphology, location, dimensions, and dynamic changes of defects and many other heart structures during the cardiac cycle.
Surgical Outcomes of Congenital Atrial Septal Defect Using da VinciTM Surgical Robot System
Korean J Thorac Cardiovasc Surg. 2013 Apr;46(2):93-7. doi: 10.5090/kjtcs.2013.46.2.93. Epub 2013 Apr 9.
Kim JE, Jung SH, Kim GS, Kim JB, Choo SJ, Chung CH, Lee JW. Source Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea. Abstract BACKGROUND: Minimally invasive cardiac surgery has emerged as an alternative to conventional open surgery. This report reviews our experience with atrial septal defect using the da VinciTM surgical robot system. MATERIALS AND METHODS: This retrospective study included 50 consecutive patients who underwent atrial septal defect repair using the da VinciTM surgical robot system between October 2007 and May 2011. Among these, 13 patients (26%) were approached through a totally endoscopic approach and the others by mini-thoracotomy. Nineteen patients had concomitant procedures including tricuspid annuloplasty (n=10), mitral valvuloplasty (n=9), and maze procedure (n=4). The mean follow-up duration was 16.9±10.4 months. RESULTS: No remnant interatrial shunt was detected by intraoperative or postoperative echocardiography. The atrial septal defects were mainly repaired by Gore-Tex patch closure (80%). There was no operative mortality or serious surgical complications. The aortic cross clamping time and cardiopulmonary bypass time were 74.1±32.2 and 157.6±49.7 minutes, respectively. The postoperative hospital stay was 5.5±3.3 days. CONCLUSION: The atrial septal defect repair with concomitant procedures like mitral valve repair or tricuspid valve repair using the da VinciTM system is a feasible method. In addition, in selected patients, complete port access can be helpful for better cosmetic results and less musculoskeletal injury. KEYWORDS: Heart septal defects, Minimally invasive cardiac surgery, Totally endoscopic approach, da VinciTM surgical robot system
Percutaneous versus surgical closure of atrial septal defects in children and adolescents
Arq Bras Cardiol. 2013 Apr;100(4):347-354.
[Article in English, Portuguese] Costa RN, Ribeiro MS, Pereira FL, Pedra SR, Jatene MB, Jatene IB, Ferreiro CR, Santana MV, Fontes VF, Pedra CA. Source Hospital do CoraÃ§Ã£o, AssociaÃ§Ã£o SanatÃ³rio SÃ-rio. Abstract BACKGROUND: There is a scarcity of data comparing percutaneous and surgical closure of the secundum atrial septal defect (ASD). OBJECTIVES: Assessment of safety and efficacy of both methods of treatment in a referral center affiliated with the Ministry of Health. METHODS: Observational, prospective, non-randomized study of two cohorts of children and adolescents younger than 14 years, treated by catheterization or surgery. Data was collected prospectively in the percutaneous group (A) and retrospectively in the surgical group (B). RESULTS: A total of 75 patients (pts) were enrolled in group A from April 2009 to October 2011 and 105 pts were treated in group B from January 2006 to January 2011. Age was older and weight was higher in group B and the ASD diameter was similar in both groups. Technical success was achieved in all procedures and there were no deaths. Complications (most minor) occurred in 68% of group B and 4% of A (p < 0.001). Rates of total occlusion or non-significant residual shunts were similar in both groups. Median hospitalization time was 1.2 days in group A and 8.4 days in group B (p < 0.001). CONCLUSION: Both treatment modalities are safe and effective, showing excellent outcomes. However, the percutaneous treatment has lower morbidity and shorter in-hospital stay length. These observations support the concept that percutaneous treatment of atrial septal defects should be regarded as the method of choice to manage selected patients with this condition.
Multiple essential roles for primary cilia in heart development
Cilia. 2012 Dec 11;1(1):23. doi: 10.1186/2046-2530-1-23.
Willaredt MA, Gorgas K, Gardner HA, Tucker KL. Source Interdisciplinary Center for Neurosciences, University of Heidelberg, Heidelberg, 69120, Germany. Kerry.Tucker@urz.uni-hd.de. Abstract BACKGROUND: The primary cilium is a microtubule-based, plasma membrane-ensheathed protrusion projecting from the basal bodies of almost all cell types in the mammalian body. In the past several years a plethora of papers has indicated a crucial role for primary cilia in the development of a wide variety of organs. We have investigated heart development in cobblestone, a hypomorphic allele of the gene encoding the intraflagellar transport protein Ift88, and uncovered a number of the most common congenital heart defects seen in newborn humans. METHODS: We generated serial sections of mutant cobblestone and wild type embryos in the region encompassing the heart and the cardiac outflow tract. The sections were further processed to generate three-dimensional reconstructions of these structures, and immunofluorescence confocal microscopy, transmission electron microscopy, and in situ hybridization were used to examine signal transduction pathways in the relevant areas. Whole mount in situ hybridization was also employed for certain developmental markers. RESULTS: In addition to an enlarged pericardium and failure of both ventricular and atrial septum formation, the cobblestone mutants displayed manifold defects in outflow tract formation, including persistent truncus arteriosus, an overriding aorta, and abnormal transformation of the aortic arches. To discern the basis of these anomalies we examined both the maintenance of primary cilia as well as endogenous and migratory embryonic cell populations that contribute to the outflow tract and atrioventricular septa. The colonization of the embryonic heart by cardiac neural crest occurred normally in the cobblestone mutant, as did the expression of Sonic hedgehog. However, with the loss of primary cilia in the mutant hearts, there was a loss of both downstream Sonic hedgehog signaling and of Islet 1 expression in the second heart field, a derivative of the pharyngeal mesoderm. In addition, defects were recorded in development of atrial laterality and ventricular myocardiogenesis. Finally, we observed a reduction in expression of Bmp4 in the outflow tract, and complete loss of expression of both Bmp2 and Bmp4 in the atrioventricular endocardial cushions. Loss of BMP2/4 signaling may result in the observed proliferative defect in the endocardial cushions, which give rise to both the atrioventricular septa as well as to the septation of the outflow tract. CONCLUSIONS: Taken together, our results potentially identify a novel link between Sonic hedgehog signaling at the primary cilium and BMP-dependent effects upon cardiogenesis. Our data further point to a potential linkage of atrioventricular septal defects, the most common congenital heart defects, to genes of the transport machinery or basal body of the cilia.
Atrial septal defect devices used in the cardiac catheterization laboratory
Prog Cardiovasc Nurs. 2009 Sep;24(3):86-9. Gervasi L, Basu S. Source The Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd., Philadelphia, PA 19104, USA. firstname.lastname@example.org
Abstract An atrial septal defect (ASD) is a hole in the atrium of the heart. There are 3 types of ASDs; sinus venosus (high in the atrial septum), secundum ASD (middle of septum), and ostium primum (low in the septum). The most common ASD is a secundum ASD. Secundum ASDs are caused by a failure of the atrial septum to close completely during the development of the heart. The most common reported symptoms are fatigue and shortness of breath. Most patients are found to have an ASD after evaluation for a murmur. All ASDs used to be repaired by open heart surgery. However, with advances in the cardiac catheterization lab and development of new devices, some secundum ASDs are able to be closed in the catheterization lab by an interventional cardiologist. There are various types of devices that may be used for closure of an ASD in the cardiac catheterization laboratory. This paper will address 2 of the devices most commonly used. Anticoagulation therapy will need to be followed for approximately 6 months and echocardiograms will need to be obtained at follow-up visits. Nurses have an important role in preparing and teaching the patient and family about the ASD closure procedure and follow-up care.