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Atrial Septal Defect: Experiences with One Hundred Cases Treated Surgically

Atrial Septal Defect: Experiences with One Hundred Cases Treated Surgically Abstract Atrial septal defects have been shown to be one of the commonest single congenital cardiac abnormalities. Many of these defects are well borne during infancy and childhood and do not manifest themselves until adult life. The pattern of symptomatology then is one of progressive reduction in myocardial reserve, followed by the gradual appearance of cyanosis and, finally, death due to a combination of right heart failure and increasing systemic anoxia. On the other hand, as reported previously by Downing and Goldberg,2 a very sizable number of infants suffer severely and die from this disease during the early months of life. Other children survive but exhibit marked degrees of physical underdevelopment due to an insufficient systemic circulation. A somewhat larger number experience sharp limitations in myocardial reserve, being unable to "keep up" with their fellows on maximal physical exertion, although quite comfortable at rest. Abnormalities of development of the interatrial References 1. Reference deleted by author. 2. Downing, D. F., and Goldberg, H.: Septal Defects , Dis. Chest 29:475, 1956.Crossref 3. Patten, B. M.: Developmental Defects of the Foramen Ovale , Am. J. Path. 14:135, 1938. 4. Edwards, J. E.: Congenital Malformations of the Heart and Great Vessels: A. Malformations of the Atrial Septal Complex , in Gould, S. E.: Pathology of the Heart , Springfield, Ill., Charles C Thomas, Publisher, 1953. 5. Watkins, E., and Gross, R.: Experiences with Surgical Repair of Atrial Septal Defects , J. Thoracic Surg. 30:469, 1955. 6. Lutembacher, R.: De la Stenose mitrale avec communication interauriculaire , Arch. mal. cœur 9:237, 1916. 7. Welch, K. J., and Kinney, I. D.: The Effect of Patent Ductus Arteriosus and Interauricular and Interventricular Septal Defects on the Development of Pulmonary Vascular Lesions , Am. J. Path. 24:729, 1948. 8. Edwards, J. E.: Pathologic Considerations in Adjustments Between the Systemic and Pulmonary Circulations , in International Symposium on Cardiovascular Surgery: Studies in Physiology, Diagnosis, and Techniques , edited by C. R. Lam, Philadelphia, W. B. Saunders Company, 1955. 9. Swan, H. J. C.; Zapata-Diaz, J.; Burchell, H. B., and Wood, E. H.: Pulmonary Hypertension in Congenital Heart Disease , Am. J. Med. 16:12, 1954.Crossref 10. Cohn, R.: An Experimental Method for the Closure of Interauricular Septal Defects in Dogs , Am. Heart J. 33:453, 1947.Crossref 11. Murray, G.: Closure of Defects in Cardia Septa , Ann. Surg. 128:843, 1948.Crossref 12. Swan, H.; Marresh, G.; Johnson, M. E., and Warner, C.: The Experimental Creation and Closure of Auricular Septal Defects , J. Thoracic Surg. 20:542, 1950. 13. Dodrill, F. D.: Exposure of the Cardia Septa , J. Thoracic Surg. 18:652, 1949. 14. Kiriluk, L. B.; Hoag, E. W., and Merendino, K. A.: Experimental Interauricular Septal Defects: Physiologic Study with Evaluation of Methods of Closure , S. Forum 2:199, 1951. 15. Hufnagel, C. A., and Gillespie, J. F.: Closure of Interauricular Septal Defects , Bull. Georgetown Univ. M. Center 4:137, 1951. 16. Bailey, C. P.; Downing, D. F.; Geckeler, G. D.; Likoff, W.; Goldberg, H.; Scott, J. C.; Tanton, O., and Redondo-Ramirez, H. P.: Congenital Interatrial Communications: Clinical and Surgical Considerations with a Description of a new Surgical Technique: Atrio-Septo-Pexy , Ann. Int. Med. 37:888, 1952.Crossref 17. Neptune, W. B.; Bailey, C. P., and Goldberg, H.: The Surgical Correction of Atrial Septal Defects Associated with Transposition of the Pulmonary Veins , J. Thoracic Surg. 25:623, 1953. 18. Bailey, C. P.; Bolton, H. E.; Jamison, W. L., and Neptune, W. B.: Atrio-Septo-Pexy for Interatrial Septal Defects , J. Thoracic Surg. 26:184, 1953. 19. Bailey, C. P.; Nichols, H. T.; Bolton, H. E.; Jamison, W. L., and Gomez, A. M.: Surgical Treatment of 46 Interatrial Septal Defects by Atrio-Septo-Pexy , Ann. Surg. 140:805, 1954.Crossref 20. Gross, R. E.; Watkins, E., Jr.; Pomeranz, A. A., and Goldsmith, E. I.: A Method for Surgical Closure of Interauricular Septal Defects , Surg. Gynec. & Obst. 96:1, 1953. 21. Kirklin, J. W.; Swann, H. J. C.; Wood, E. H.; Burchell, H. B., and Edwards, J.: Anatomic, Physiologic, and Surgical Considerations in Repair of Interatrial Communications in Man , J. Thoracic Surg. 29:37, 1955. 22. Sondergaard, T.; Sorensen, H. R.; Poulsen, T., and Andersen, I.: Experimental Production of Atrial Septal Defects Under Direct Vision , Acta chir. scandinav. , 107, 477, 1954. 23. Björk, V. O., and Crafoord, C.: The Surgical Closure of Interauricular Septal Defects , J. Thoracic Surg. 26:300, 1953. 24. Gibbon, J. H.: Application of a Mechanical Heart and Lung Apparatus to Cardiac Surgery , Minnesota Med. 37:171, 1954. 25. Lewis, F. J., and Taufic, M.: Closure of Atrial Septal Defects with the Aid of Hypothermia: Experimental Accomplishments and the Report of One Successful Case , Surgery 33:52, 1953. 26. Swan, H.; Zeavin, I.; Blount, S. G., Jr., and Virtue, R. W.: Surgery by Direct Vision in the Open Heart During Hypothermia , J. A. M. A. 153:1081, 1953.Crossref 27. Bailey, C. P., in discussion on Watkins, E., and Gross, R.: Experiences with Surgical Repair of Atrial Septal Defects , J. Thoracic Surg. 30:469, 1955. 28. Goldberg, H. and Downing, D. F.: The Physiological and Clinical Changes Following Closure of Atrial Septal Defects by Atrio-Septo-Pexy , Am. Heart J. 49:862, 1955.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

Atrial Septal Defect: Experiences with One Hundred Cases Treated Surgically

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References (31)

Publisher
American Medical Association
Copyright
Copyright © 1957 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1957.01280090049009
Publisher site
See Article on Publisher Site

Abstract

Abstract Atrial septal defects have been shown to be one of the commonest single congenital cardiac abnormalities. Many of these defects are well borne during infancy and childhood and do not manifest themselves until adult life. The pattern of symptomatology then is one of progressive reduction in myocardial reserve, followed by the gradual appearance of cyanosis and, finally, death due to a combination of right heart failure and increasing systemic anoxia. On the other hand, as reported previously by Downing and Goldberg,2 a very sizable number of infants suffer severely and die from this disease during the early months of life. Other children survive but exhibit marked degrees of physical underdevelopment due to an insufficient systemic circulation. A somewhat larger number experience sharp limitations in myocardial reserve, being unable to "keep up" with their fellows on maximal physical exertion, although quite comfortable at rest. Abnormalities of development of the interatrial References 1. Reference deleted by author. 2. Downing, D. F., and Goldberg, H.: Septal Defects , Dis. Chest 29:475, 1956.Crossref 3. Patten, B. M.: Developmental Defects of the Foramen Ovale , Am. J. Path. 14:135, 1938. 4. Edwards, J. E.: Congenital Malformations of the Heart and Great Vessels: A. Malformations of the Atrial Septal Complex , in Gould, S. E.: Pathology of the Heart , Springfield, Ill., Charles C Thomas, Publisher, 1953. 5. Watkins, E., and Gross, R.: Experiences with Surgical Repair of Atrial Septal Defects , J. Thoracic Surg. 30:469, 1955. 6. Lutembacher, R.: De la Stenose mitrale avec communication interauriculaire , Arch. mal. cœur 9:237, 1916. 7. Welch, K. J., and Kinney, I. D.: The Effect of Patent Ductus Arteriosus and Interauricular and Interventricular Septal Defects on the Development of Pulmonary Vascular Lesions , Am. J. Path. 24:729, 1948. 8. Edwards, J. E.: Pathologic Considerations in Adjustments Between the Systemic and Pulmonary Circulations , in International Symposium on Cardiovascular Surgery: Studies in Physiology, Diagnosis, and Techniques , edited by C. R. Lam, Philadelphia, W. B. Saunders Company, 1955. 9. Swan, H. J. C.; Zapata-Diaz, J.; Burchell, H. B., and Wood, E. H.: Pulmonary Hypertension in Congenital Heart Disease , Am. J. Med. 16:12, 1954.Crossref 10. Cohn, R.: An Experimental Method for the Closure of Interauricular Septal Defects in Dogs , Am. Heart J. 33:453, 1947.Crossref 11. Murray, G.: Closure of Defects in Cardia Septa , Ann. Surg. 128:843, 1948.Crossref 12. Swan, H.; Marresh, G.; Johnson, M. E., and Warner, C.: The Experimental Creation and Closure of Auricular Septal Defects , J. Thoracic Surg. 20:542, 1950. 13. Dodrill, F. D.: Exposure of the Cardia Septa , J. Thoracic Surg. 18:652, 1949. 14. Kiriluk, L. B.; Hoag, E. W., and Merendino, K. A.: Experimental Interauricular Septal Defects: Physiologic Study with Evaluation of Methods of Closure , S. Forum 2:199, 1951. 15. Hufnagel, C. A., and Gillespie, J. F.: Closure of Interauricular Septal Defects , Bull. Georgetown Univ. M. Center 4:137, 1951. 16. Bailey, C. P.; Downing, D. F.; Geckeler, G. D.; Likoff, W.; Goldberg, H.; Scott, J. C.; Tanton, O., and Redondo-Ramirez, H. P.: Congenital Interatrial Communications: Clinical and Surgical Considerations with a Description of a new Surgical Technique: Atrio-Septo-Pexy , Ann. Int. Med. 37:888, 1952.Crossref 17. Neptune, W. B.; Bailey, C. P., and Goldberg, H.: The Surgical Correction of Atrial Septal Defects Associated with Transposition of the Pulmonary Veins , J. Thoracic Surg. 25:623, 1953. 18. Bailey, C. P.; Bolton, H. E.; Jamison, W. L., and Neptune, W. B.: Atrio-Septo-Pexy for Interatrial Septal Defects , J. Thoracic Surg. 26:184, 1953. 19. Bailey, C. P.; Nichols, H. T.; Bolton, H. E.; Jamison, W. L., and Gomez, A. M.: Surgical Treatment of 46 Interatrial Septal Defects by Atrio-Septo-Pexy , Ann. Surg. 140:805, 1954.Crossref 20. Gross, R. E.; Watkins, E., Jr.; Pomeranz, A. A., and Goldsmith, E. I.: A Method for Surgical Closure of Interauricular Septal Defects , Surg. Gynec. & Obst. 96:1, 1953. 21. Kirklin, J. W.; Swann, H. J. C.; Wood, E. H.; Burchell, H. B., and Edwards, J.: Anatomic, Physiologic, and Surgical Considerations in Repair of Interatrial Communications in Man , J. Thoracic Surg. 29:37, 1955. 22. Sondergaard, T.; Sorensen, H. R.; Poulsen, T., and Andersen, I.: Experimental Production of Atrial Septal Defects Under Direct Vision , Acta chir. scandinav. , 107, 477, 1954. 23. Björk, V. O., and Crafoord, C.: The Surgical Closure of Interauricular Septal Defects , J. Thoracic Surg. 26:300, 1953. 24. Gibbon, J. H.: Application of a Mechanical Heart and Lung Apparatus to Cardiac Surgery , Minnesota Med. 37:171, 1954. 25. Lewis, F. J., and Taufic, M.: Closure of Atrial Septal Defects with the Aid of Hypothermia: Experimental Accomplishments and the Report of One Successful Case , Surgery 33:52, 1953. 26. Swan, H.; Zeavin, I.; Blount, S. G., Jr., and Virtue, R. W.: Surgery by Direct Vision in the Open Heart During Hypothermia , J. A. M. A. 153:1081, 1953.Crossref 27. Bailey, C. P., in discussion on Watkins, E., and Gross, R.: Experiences with Surgical Repair of Atrial Septal Defects , J. Thoracic Surg. 30:469, 1955. 28. Goldberg, H. and Downing, D. F.: The Physiological and Clinical Changes Following Closure of Atrial Septal Defects by Atrio-Septo-Pexy , Am. Heart J. 49:862, 1955.Crossref

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A.M.A. Archives SurgeryAmerican Medical Association

Published: Mar 1, 1957

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