Atrial Septal Defects

  • Bradley J. Harlan
  • Albert Starr
  • Fredic M. Harwin
  • Alain Carpentier


Atrial septal defect (ASD) was the first cardiac malformation to be successfully treated surgically using the mechanical pump oxygenator. Following Gibbon’s pioneering report,14 surgical risk for closure of most defects became minimal and has been near 0% for the past three decades. Indications for surgery and surgical techniques for the three main types of defects—sinus venosus, ostium secundum, and ostium primum—are straightforward and widely accepted.


Coronary Sinus Atrial Septal Defect Azygos Vein Transcatheter Closure Sinus Venosus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Anderson RH, Zuberbuhler JR, Penkoske PA, Neches WH: Of cleft, commissures, and things. J Thorac Cardiovasc Surg 90:605,1985.PubMedGoogle Scholar
  2. 2.
    Beck W, Swan HJC, Burchell HB, Kirklin JW: Pulmonary vascular resistance after repair of atrial septal defects in patients with pulmonary hypertension. Circulation 22:938,1960.PubMedGoogle Scholar
  3. 3.
    Becker AE, Anderson RH: Atrioventricular septal defects: What’s in a name? J Thorac Cardiovasc Surg 83:461,1982.PubMedGoogle Scholar
  4. 4.
    Bedford DE, Sellors TH, Sommerville W, Belcher JR, Besterman EMM: Atrial septal defect and its surgical treatment. Lancet 1:1255,1957.CrossRefGoogle Scholar
  5. 5.
    Braudo JL, Nadas AS, Rudolph AM, Neuhauser EBD: Atrial septal defects in children: a clinical study with special emphasis on indications for operative repair. Pediatrics 14:618,1954.PubMedGoogle Scholar
  6. 6.
    Burrett JB, White PD: Large interauricular septal defect with particular reference to diagnosis and longevity. Am J Med Sci 209:355,1945.CrossRefGoogle Scholar
  7. 7.
    Campbell M, Neill C, Suzman S: Prognosis of atrial septal defect. Br Med J 1: 1375,1957.PubMedCrossRefGoogle Scholar
  8. 8.
    Carpentier A: Surgical anatomy and management of the mitral component of atrioventricular canal defects. In Anderson RH, Shinebourne EA (eds): Pediatric Cardiology 1977. Edinburgh, Churchill Livingstone, 1978, p 477.Google Scholar
  9. 9.
    Clark EB, Roland JMA, Varghese PJ, Neill CA, Haller JA: Should the sinus venosus type ASD be closed? A review of the atrial conduction defects and surgical results in twenty-eight children (abstr). Am J Cardiol 35:127,1975.Google Scholar
  10. 10.
    Cooley DA: Results of surgical treatment of atrial septal defects. Am J Cardiol 6: 605,1960.PubMedCrossRefGoogle Scholar
  11. 11.
    Davia JE, Cheitlin MD, Bedynek JL: Sinus venosus atrial septal defect: analysis of fifty cases. Am Heart J 85:177,1973.PubMedCrossRefGoogle Scholar
  12. 12.
    Dexter L: Atrial septal defect. Br Heart J 18:209,1956.PubMedCrossRefGoogle Scholar
  13. 13.
    Forgang K, Simonsen S, Andersen A, Efskind L: Atrial septal defect of secundum type in the middle-aged. Am Heart J 94:44,1977.CrossRefGoogle Scholar
  14. 14.
    Gibbon JH Jr: Application of a mechanical heart and lung apparatus to cardiac surgery. Minn Med 37:171,1954.PubMedGoogle Scholar
  15. 15.
    Hairston P, Parker EF, Arrants JE, Bradham RR, Lee WH: The adult atrial septal defect. Ann Surg 179:799,1974.PubMedCrossRefGoogle Scholar
  16. 16.
    Hallman GL, Cooley DA: Surgical Treatment of Congenital Heart Disease, 2nd ed. Philadelphia, Lea & Febiger, 1975, p 85.Google Scholar
  17. 17.
    Horvarth KA, Burke RP, Collins JJ Jr, Cohn LH: Surgical treatment of adult atrial septal defect: early and long-term results. J Am Coll Cardiol 20:1156,1992.CrossRefGoogle Scholar
  18. 18.
    Huhta JC, Glasgow P, Murphy DJ Jr, Gutgesell HP, Ott D, McNamara DG, Smith EO: Surgery without catheterization for congenital heart defects: management of 100 patients. J Am Coll Cardiol 9:823,1987.PubMedCrossRefGoogle Scholar
  19. 19.
    King RM, Puga FJ, Danielson GK, Schaff HV, Julsrud PR, Feldt RH: Prognostic factors and surgical treatment of partial atrioventricular canal. Circulation 74(Suppl I):I-42,1986.Google Scholar
  20. 20.
    King TD, Mills NL: Secundum atrial septal defects: nonoperative closure during cardiac catheterization. JAMA 235:2506,1976.PubMedCrossRefGoogle Scholar
  21. 21.
    Kirklin JW, Ellis FH, Wood EH: Treatment of anomalous pulmonary venous connections in association with interatrial communications. Surgery 39:389,1956.PubMedGoogle Scholar
  22. 22.
    Kyger ER III, Frazier OH, Cooley DA, Gillette PC, Reul GJ Jr, Sandiford FM, Wukasch DC: Sinus venosus atrial septal defect: early and late results following closure in 109 patients. Ann Thorac Surg 75:248,1978.Google Scholar
  23. 23.
    Lee ME, Sade RM: Coronary sinus septal defect: surgical considerations. J Thorac Cardiovasc Surg 78:563,1979.PubMedGoogle Scholar
  24. 24.
    Lipshultz SE, Sanders SP, Mayer JE, Colan SD, Lock JE: Are routine preoperative cardiac catheterization and angiography necessary before repair of ostium primum atrial septal defect? J Am Coll Cardiol 11:373,1988.PubMedCrossRefGoogle Scholar
  25. 25.
    Losay J, Rosenthal A, Castaneda AR, Bernhard WH, Nadas AS: Repair of atrial septal defect primum. J Thorac Cardiovasc Surg 75:248,1978.PubMedGoogle Scholar
  26. 26.
    McMullan MH, McGoon DC, Wallace RB, Danielson GK, Weidman WH: Surgical treatment of partial atrioventricular canal. Arch Surg 107:705,1973.PubMedGoogle Scholar
  27. 27.
    Meijboom EJ, Ebels T, Anderson RH, Schasfoort-van Leeuwen MJM, Deanfield JE, Eijgelaar A, Homan JN, van der Heide JNH: Left atrioventricular valve after surgical repair in atrioventricular septal defect with separate valve orifices (“Ostium primum atrial septal defect”): an echo-doppler study. Am J Cardiol 57: 433,1986.PubMedCrossRefGoogle Scholar
  28. 28.
    Murphy JG, Gersh BJ, McGoon MD, Mair DD, Porter CJ, Ilstrup DM, McGoon DC, Puga FJ, Kirklin JW, Danielson GK: Long-term outcome after surgical repair of isolated atrial septal defect: follow-up at 27 to 32 years. N Engl J Med 323: 1645,1990.PubMedCrossRefGoogle Scholar
  29. 29.
    Penkoske PA, Neches WH, Anderson RH, Zuberbuhler JR: Further observations on the morphology of atrioventricular septal defects. J Thorac Cardiovasc Surg 90: 611,1985.PubMedGoogle Scholar
  30. 30.
    Phillips SJ, Okies JE, Henken D, Sunderland CO, Starr A: Complex of secundum atrial septal defect and congestive heart failure in infants. J Thorac Cardiovasc Surg 70:696,1975.PubMedGoogle Scholar
  31. 31.
    Piccoli GP, Gerlis LM, Wilkinson JL, Lozsadi K, Macartney FJ, Anderson RH: Morphology and classification of atrioventricular defects. Br Heart J 42:621,1979.PubMedCrossRefGoogle Scholar
  32. 32.
    Pollick C, Sullivan H, Cujec B, Wilansky S: Doppler color-flow imaging assessment of shunt size in atrial septal defect. Circulation 78:522,1988.PubMedCrossRefGoogle Scholar
  33. 33.
    Pozzi M, Remig J, Fimmers R, Urban AE: Atrioventricular septal defects: analysis of shortand medium-term results. J Thorac Cardiovasc Surg 101:138,1991.PubMedGoogle Scholar
  34. 34.
    Quaegebeur J, Kirklin JW, Pacifico AD, Bargeron LM: Surgical experience with unroofed coronary sinus. Ann Thorac Surg 27:418,1979.PubMedCrossRefGoogle Scholar
  35. 35.
    Rahimtoola SH, Kirklin JW, Burchell HB: Atrial septal defect. Circulation 37(Suppl V):V–2,1968.Google Scholar
  36. 36.
    Rashkind WJ: Transcatheter treatment of congenital heart disease. Circulation 67: 711,1983.PubMedCrossRefGoogle Scholar
  37. 37.
    Rome JJ, Keane JF, Perry SB, Spevak PJ, Lock JE: Double-umbrella closure of atrial defects: initial clinical application. Circulation 82:751,1990.PubMedCrossRefGoogle Scholar
  38. 38.
    Ross DN: The sinus venosus type of atrial septal defect. Guys Hosp Rep 105: 376,1956.PubMedGoogle Scholar
  39. 39.
    Schuster SR, Gross RE, Colodny AH: Surgical management of anomalous right pulmonary venous drainage to the superior vena cava, associated with superior marginal defect of the atrial septum. Surgery 51:805,1962.PubMedGoogle Scholar
  40. 40.
    Shub C, Tajik AJ, Seward JB, Hagler DJ, Danielson GK: Surgical repair of uncomplicated atrial septal defect without “routine” preoperative cardiac catheterization. J Am Coll Cardiol 6:49,1985.PubMedCrossRefGoogle Scholar
  41. 41.
    Somerville J: Ostium primum defect: factors causing deterioration in the natural history. Br Heart J 27:413,1965.PubMedCrossRefGoogle Scholar
  42. 42.
    Swan HJC, Zapata-Diaz J, Burchell HB, Wood EH: Pulmonary hypertension in congenital heart disease. Am J Med 16:12,1954.PubMedCrossRefGoogle Scholar
  43. 43.
    Trusler GA, Kazenelson G, Freedom RM, Williams WG, Rowe RD: Late results following repair of partial anomalous pulmonary venous connection with sinus venosus atrial septal defect. J Thorac Cardiovasc Surg 79:776,1980.PubMedGoogle Scholar
  44. 44.
    USCI/Bard: Personal communication. 1993.Google Scholar
  45. 45.
    Van Mierop LHS, Alley RD: The management of the cleft mitral valve in endocardial cushion defects. Ann Thorac Surg 2:416,1966.PubMedCrossRefGoogle Scholar
  46. 46.
    Watson H (ed): Paediatric Cardiology. St Louis, CV Mosby Co, 1968.Google Scholar
  47. 47.
    Williams WH, Zorn-Chelton S, Raviele AA, Michalik RE, Guyton RA, Dooley KJ, Hatcher CR: Extracardiac atrial pedicle conduit repair of partial anomalous pulmonary venous connection to the superior vena cava in children. Ann Thorac Surg 38:345,1984.PubMedCrossRefGoogle Scholar
  48. 48.
    Young D: Later results of closure of secundum atrial septal defect in children. Am J Cardiol 31:14,1973.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York, Inc. 1995

Authors and Affiliations

  • Bradley J. Harlan
    • 1
    • 2
    • 3
  • Albert Starr
    • 3
    • 4
    • 5
  • Fredic M. Harwin
    • 6
  • Alain Carpentier
    • 7
  1. 1.Section of Thoracic and Cardiovascular SurgerySutter Memorial HospitalSacramentoUSA
  2. 2.Davis Medical SchoolUniversity of CaliforniaSacramentoUSA
  3. 3.Oregon Health Sciences UniversityPortlandUSA
  4. 4.Heart Institute at St. Vincent HospitalPortlandUSA
  5. 5.Starr-Wood Cardiac Group, P.C.PortlandUSA
  6. 6.Harwin StudiosPortlandUSA
  7. 7.Hôpital BroussaisUniversity of ParisParisFrance

Personalised recommendations