Ostium primum and atrioventricularis communis defects: Clinical manifestations and surgical treatment

Abstract

Clinical findings in atrial septal defect are highly variable due to the different location and size of the communication and presence of associated valvular anomalies in certain types. Low defects of the atrial septum are known as ostim primum is cases wher the A-V valves are normal and as atrioventricularis communis in instances in which the mitral or tricuspid valves are involved. Ostium primum and atrioventricularis communis defects, particularly the latter, constitute a more serious physiologic problem clinically because of the complicated physiologic disturbance which results. Diagnosis is usually confirmed only by electrocardiography and cardiac catheterization. Surgical correction of ostim primum and A-V communis may be accomplished using a pump oxygenator for cardiopulmonary bypass. Technic of repair depends upon the anatomic findings in each defect. Operative repair was successful in 5 patients with ostium primum defects. Results in the A-V communis defects were less satisfactory. In partial communis 2 patients out of 3 survived operation and in complete communis 2 out of 7 survived. Due to the severe anatomic defects present in many complete defects with severe valvular and ventricular septal anomalies, it may be impossible to completely correct this lesion. Nevertheless, an attempt at surgical repair in even the most complicated lesions is justified by the grave prognosis and by the known successful results in some patients.