Ostium Secundum True Defect in Fossa Ovalis. Ostium Primum Defect. Sinus venosus defect, at junction of RA/SVC ass with anomalous PV return. IVC form of Sinus venosus defect. CS septal defect ( bet CS/LA, L R shunt due to unroofed CS.
Common. Present at any age. F:M 70:30 in secundum F:M 50:50 for Sin Venosus & Ost Primum. Down Syndrome 40% CHD 40% AV SD. DiGeorge / Ellis-Van Syndromes: Ost Primum.
Sinus Venosus ASD 5-10%. Post aspect: RA free wall Sup border Absent (SVC). Anomalous connection of Rt PVs to SVC or RA. TEE, MRI, CT. Should be looked for in any RA &/or RV unexplained dilatation. Surgical closure only possibility.
AtrioVentricular septal defects Common AV junction. Separate AV valves in partial form. Common AV valve in Complete form.
Secundum ASD with persistant L SVC CS. Primum ASD Rt heart dilataion. “Tri leaflet AV” valve –cleft MV- regurgitation. Pachute or Double orifice MV. Surgical repair of ASD + restoration or preservation of competence. 96% 20 year survival. 7 late death, 15 reoperation for residual regurgitation, 3 for subaortic stenosis development.
Clinical features Asymptomatic initially. Not related to size exclusively! Exercise intolerance. A Fib/Flutter (increase Sx). Rt Heart Failure with severe TR. Pulm HTN (increased P flow). Cyanosis (inf sinus venosus)
Pink, unless advanced P HTN. RV lift on hel expiration. Palpable PA in 2 nd Lt IC. “wide, Fixed