Septum Primum

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Richard Van Praagh - One of the best experts on this subject based on the ideXlab platform.

  • isolated severe leftward displacement of the Septum Primum anatomic and 3d echocardiographic findings and surgical repair
    Interactive Cardiovascular and Thoracic Surgery, 2017
    Co-Authors: Fabio Cuttone, Khaled Hadeed, Francois Lacourgayet, H Lucron, Sebastien Hascoet, Philippe Acar, Bertrand Leobon, Richard Van Praagh
    Abstract:

    OBJECTIVES: Leftward displacement of the Septum Primum is usually described as associated with hypoplastic left heart syndrome or visceral heterotaxy. This rare malformation results in partially or totally anomalous pulmonary venous drainage with a normal connection of the pulmonary veins to the left atrium, depending on the degree of septal shift. We report the 3D echocardiographic and anatomic findings as well as the surgical repair in a series of isolated severe leftward displacement of the Septum Primum, responsible for totally anomalous pulmonary venous drainage. METHODS: Three patients presenting with situs solitus and extreme leftward displacement of the Septum Primum were included. All of the pulmonary veins drained anomalously into the anatomical right atrium, and the distance between the mitral valve and the abnormal Septum Primum was greatly reduced, compromising the size of the left atrial chamber, but with normal left ventricle diameters. Preoperative 3D echocardiographic findings are reported. We achieved a biventricular surgical repair in all cases. The atrial septation was accomplished using an autologous pericardial patch after removing the abnormal septal membrane. RESULTS: The postoperative course was free from any cardiovascular complications. Echocardiographic scans showed a harmonious reconstruction without pulmonary venous obstructions or stenosis. CONCLUSIONS: This article reports the severe leftward displacement of the Septum Primum presented as an isolated cardiac malformation; 3D transthoracic echocardiography allowed an accurate diagnosis of this malformation and helped in choosing the best surgical strategy.

  • partial or total direct pulmonary venous drainage to right atrium due to malposition of Septum Primum anatomic and echocardiographic findings and surgical treatment a study based on 36 cases
    Chest, 1995
    Co-Authors: Richard Van Praagh, Stella Van Praagh, Maria E Carrera, Stephen P Sanders, John E Mayer
    Abstract:

    The clinical and anatomic findings in 36 patients (21 postmortem cases and 15 living patients) with partially anomalous (16 [44%]) or totally anomalous (20 [56%]) pulmonary venous drainage directly to the right atrium constitute the material basis of this report. Displacement of Septum Primum—leftward in atrial situs solitus or rightward in atrial situs inversus—was present in all and appeared responsible for the anomalous pulmonary venous drainage. The pulmonary veins were connected with what normally constitutes the posterior wall of the left atrium, which became incorporated into the right atrium because of atrial septal displacement. This abnormality occurred predominantly in patients with visceral heterotaxy, usually with polysplenia, or rarely with asplenia or a normally formed spleen. Poor development or absence of Septum secundum appeared responsible for the malposition of Septum Primum. Echocardiographic recognition of the displacement of Septum Primum facilitated surgical management.

  • Clinical Investigations: Cardiology and Cardiac SurgeryPartial or Total Direct Pulmonary Venous Drainage to Right Atrium Due to Malposition of Septum Primum: Anatomic and Echocardiographic Findings and Surgical Treatment: A Study Based on 36 Cases
    Chest, 1995
    Co-Authors: Stella Van Praagh, Maria E Carrera, Stephen P Sanders, John E Mayer, Richard Van Praagh
    Abstract:

    The clinical and anatomic findings in 36 patients (21 postmortem cases and 15 living patients) with partially anomalous (16 [44%]) or totally anomalous (20 [56%]) pulmonary venous drainage directly to the right atrium constitute the material basis of this report. Displacement of Septum Primum—leftward in atrial situs solitus or rightward in atrial situs inversus—was present in all and appeared responsible for the anomalous pulmonary venous drainage. The pulmonary veins were connected with what normally constitutes the posterior wall of the left atrium, which became incorporated into the right atrium because of atrial septal displacement. This abnormality occurred predominantly in patients with visceral heterotaxy, usually with polysplenia, or rarely with asplenia or a normally formed spleen. Poor development or absence of Septum secundum appeared responsible for the malposition of Septum Primum. Echocardiographic recognition of the displacement of Septum Primum facilitated surgical management.

Stella Van Praagh - One of the best experts on this subject based on the ideXlab platform.

Savitri Shrivastava - One of the best experts on this subject based on the ideXlab platform.

Maria E Carrera - One of the best experts on this subject based on the ideXlab platform.

John E Mayer - One of the best experts on this subject based on the ideXlab platform.