Correspondence to: Prof. Siew Yen Ho. Email: ku. Received Dec 5; Accepted Feb 1. Copyright Journal of Thoracic Disease.
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Correspondence to: Prof. Siew Yen Ho. Email: ku. Received Dec 5; Accepted Feb 1. Copyright Journal of Thoracic Disease. All rights reserved. This article has been cited by other articles in PMC. Abstract Deficiencies in the septum separating the two atrial chambers are among the most common of congenital heart malformations.
This article reviews the developmental aspects of the partitioning of the primitive atrium into right and left atrial chambers, the anatomical components of the atrial septum, and deficiencies that produce the various types of interatrial communications. Knowledge of the components of the true atrial septum in the developed heart clarifies the morphology of various types of interatrial communications.
The oval fossa defect also termed secundum ASD is located within the true septum. The patent foramen ovale PFO is a tunnel-like passageway between the free edge of the overlapping ovale fossa valve and its muscular rim. Other defects such as superior and inferior sinus venosus defects, coronary sinus defects, and ostium primum defects lie outside the area of the true septum.
Keywords: Atrial septal defect ASD , coronary sinus defect, patent foramen ovale PFO , sinus venosus defect Introduction Understanding the atrial septum is crucial for all specialists working in congenital heart disease because atrial septal defects ASDs , account for the second most common congenital heart malformation. ASDs have a worldwide prevalence of 1.
By definition, an ASD is a direct communication between the atrial cavities that allows shunting of blood. These holes can occur in isolation, or in association with other defects, including the most complex forms of congenital heart disease. However, there are variants of interatrial communications that are located outside the area of the true atrial septum.
For a better understanding of the anatomy of the various types of holes we review in this article the developmental anatomy of the normal atrial septum, its structural components, and the morphology of the various types of interatrial communications relevant to cardiologists, fetal and paediatric cardiologists, echocardiographers, obstetric sonographers, interventionalists, electrophysiologists and surgeons.
Developmental anatomy The embryonic heart develops initially as a straight tube with an arterial pole at the superior end and a venous pole at the inferior end, the latter also being the tube inlet.
This tube is initially attached to the body, along its length posteriorly by mesocardium but later most of it separates from this mesocardium via a process of looping. The cardiac ventricles develop from the tube; whilst the inferior venous inlet pole expands to form the atria during the looping process.
Blood is brought into the right and left sides of the developing atria by large venous channels. These two venous channels develop into the horns of the sinus venosus into which drain the common cardinal veins ducts of Cuvier as well as the vitelline veins from the yolk sac, and the umbilical veins from the placenta. The arterial pole, which is the outlet part of the heart tube, also expands by recruitment of extracardiac cells 2. There are no borders between the primitive atrium and the sinus venosus by the fourth week of gestation.
The horns of the sinus venosus develop asymmetrically. The right horn enlarges quickly, whilst the left horn which is the precursor of the coronary sinus, becomes smaller, merging into the developing left atrioventricular junction. The left duct of Cuvier drains into the coronary sinus. Eventually all the systemic venous blood drains to the right part of the primitive atrium, which joins the developing atrioventricular junction at the atrioventricular canal Figure 1.
Anatomy of the atrial septum and interatrial communications
El dispositivo amplatzer se ha estandarizado como pieza fundamental del tratamiento endovascular con numerosas revisiones que reportan excelentes resultados con cerca de , dispositivos implantados. The technic and device are chosen according to the hemodynamic alterations, defect size and anatomical location. The Amplatzer device has been positioned as an excellent choice for the treatment of ASD based on clinical experience and scientific evidence. The aim of this paper is, in relation to a clinical case, review current concepts about this congenital heart disease and the amplatzer device. El dispositivo Amplatzer se ha estandarizado como pieza fundamental del manejo endovascular con numerosas revisiones que reportan excelentes resultados con cerca de , dispositivos implantados. Correspondencia: Dr.
¿Qué es la comunicación interauricular?