Novel Imaging of Atrial Septal Defects in Isolated Human Hearts
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Within the adult population living with congenital heart defects, approximately 20 % have an atrial septal defect, which suggests that only 0.4–0.05 % of the entire adult population has an atrial septal defect (ASD). In patients with a left to right atrial shunt, treatments may include closure of the defect with a transcatheter device and/or surgical repair. From the perspective of a physician or engineer, it is vitally important to understand the anatomical nuances of such defects, not only to offer the most optimal treatment for the patient but also to call attention to the potential anatomy of ASDs which may go undetected. To do so, we reanimated two human hearts deemed not viable for transplant from 56-year-old and 68-year-old males. Neither patient history reported any heart conditions that would suggest an atrial defect, yet an ASD was found in each heart. Here, we present sets of images, videos, and 3D reconstructions that provide a clearer view of the anatomy of ASDs in functional human hearts. With an enhanced understanding of 3D functional aspects of ASDs, physicians can make improved decisions regarding treatment options and engineers can optimize device designs.
KeywordsCongenital defects Magnetic resonance imaging Patent foramen ovale Oval foramen Persistent patency Atrial septal defect
This research was conducted using human organs donated by generous families via LifeSource, to be used for the advancement of medical and scientific outcomes. This work was funded in part by NIH training grant 5T32AR007612 and by endowment funding from Medtronic, Inc.
Endoscopic image of the atrial septal defect (ASD) from Heart #1 as seen from the right atrium (RA). Next the cine of the contrast-enhanced MRI image of the ASD in Heart #2. The atrial shunt is highlighted with an arrow, and the contrast injected into the left atrium can be seen jetting through the defect from the left atrium (LA) into the right atrium. (MPG 4076 kb)
Rotational views of the 3D reconstructed hearts in both an anatomically correct manner as well as about their short axes. The final portion of the video shows a close-up of the atrial septal defect (ASD) relative to the heart’s anatomy. (MPG 23373 kb)