Atrial Septal Defect, Ostium Primum Differential Diagnoses

  • Author: Shannon M Rivenes, MD; Chief Editor: Steven R Neish, MD, SM   more...
 
Updated: Aug 11, 2010
 
 

Differential Diagnoses

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Contributor Information and Disclosures
Author

Shannon M Rivenes, MD  Assistant Professor, Department of Pediatrics, Division of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine

Shannon M Rivenes, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American College of Cardiology, American Heart Association, and American Society of Echocardiography

Disclosure: Nothing to disclose.

Specialty Editor Board

Paul M Seib, MD  Associate Professor of Pediatrics, University of Arkansas for Medical Sciences; Medical Director, Cardiac Catheterization Laboratory, Co-Medical Director, Cardiovascular Intensive Care Unit, Arkansas Children's Hospital

Paul M Seib, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, American Heart Association, Arkansas Medical Society, International Society for Heart and Lung Transplantation, and Society for Cardiac Angiography and Interventions

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Pharmacy Editor, eMedicine

Disclosure: Nothing to disclose.

Alvin J Chin, MD  Professor of Pediatrics, University of Pennsylvania School of Medicine; Attending Physician, Cardiology Division, Children's Hospital of Philadelphia

Alvin J Chin, MD, is a member of the following medical societies: American Association for the Advancement of Science, American Heart Association, and Society for Developmental Biology

Disclosure: Nothing to disclose.

Gilbert Z Herzberg, MD  Assistant Professor, Department of Pediatrics, Section of Pediatric Cardiology, New York Medical College; Consulting Staff, Department of Pediatrics, Sound Shore Medical Center

Gilbert Z Herzberg, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Chief Editor

Steven R Neish, MD, SM  Director of Pediatric Cardiology Fellowship Program, Associate Professor, Department of Pediatrics, Baylor College of Medicine

Steven R Neish, MD, SM is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, and American Heart Association

Disclosure: Nothing to disclose.

References

  1. Murashita T, Kubota T, Oba J, et al. Left atrioventricular valve regurgitation after repair of incomplete atrioventricular septal defect. Ann Thorac Surg. Jun 2004;77(6):2157-62. [Medline].

  2. Morris CD, Reller MD, Menashe VD. Thirty-year incidence of infective endocarditis after surgery for congenital heart defect. JAMA. Feb 25 1998;279(8):599-603. [Medline].

  3. Najm HK, Williams WG, Chuaratanaphong S, et al. Primum atrial septal defect in children: early results, risk factors, and freedom from reoperation. Ann Thorac Surg. Sep 1998;66(3):829-35. [Medline].

  4. Michielon G, Stellin G, Rizzoli G, Milanesi O, Rubino M, Moreolo GS, et al. Left atrioventricular valve incompetence after repair of common atrioventricular canal defects. Ann Thorac Surg. Dec 1995;60(6 Suppl):S604-9. [Medline].

  5. Bergin ML, Warnes CA, Tajik AJ, Danielson GK. Partial atrioventricular canal defect: long-term follow-up after initial repair in patients > or = 40 years old. J Am Coll Cardiol. Apr 1995;25(5):1189-94. [Medline].

  6. Agny M, Cobanoglu A. Repair of Partial Atrioventricular Septal Defect in Children Less than Five Years of Age: Late Results. Ann Thorac Surg. May 1999;67(5):1412-4. [Medline].

  7. Arky, Ronald. Physicians' Desk Reference. 52nd ed. Montvale, NJ: Medical Economics Co Inc; 1998:784-7, 1051-1062, 1219-1221.

  8. Castaneda AR, Jonas RA, Mayer JE. Atrioventricular canal defect. In: Cardiac Surgery of the Neonate and Infant. 1994:167-86.

  9. Cheitlin MD, Douglas PS, Parmley WW. 26th Bethesda conference: recommendations for determining eligibility for competition in athletes with cardiovascular abnormalities. Task Force 2: acquired valvular heart disease. J Am Coll Cardiol. Oct 1994;24(4):874-80. [Medline].

  10. Del Nido PJ, Bichell DP. Minimal-access surgery for congenital heart defects. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 1998;1():75-80. [Medline].

  11. Garson A Jr, Bricker JT, Fisher DJ. The Science and Practice of Pediatric Cardiology. 2nd ed. Williams & Wilkins; 1998:1158-179.

  12. Giamberti A, Mazzera E, Di Chiara L, Ferretti E, Pasquini L, Di Donato RM. Right submammary minithoracotomy for repair of congenital heart defects. Eur J Cardiothorac Surg. Dec 2000;18(6):678-82. [Medline].

  13. Gilman AG, Goodman LS, Nies AS. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 8th ed. 1990:721-5, 749-63, 814-839.

  14. Graham TP Jr, Bricker JT, James FW, Strong WB. 26th Bethesda conference: recommendations for determining eligibility for competition in athletes with cardiovascular abnormalities. Task Force 1: congenital heart disease. J Am Coll Cardiol. Oct 1994;24(4):867-73. [Medline].

  15. Kaur A, Srivastava S, Lytrivi ID, Nguyen K, Lai WW, Parness IA. Echocardiographic evaluation and surgical implications of common atrioventricular canal defects with absent or diminutive ostium primum defect. Am J Cardiol. Jun 1 2008;101(11):1648-51. [Medline].

  16. Lange A, Mankad P, Walayat M, et al. Transthoracic three-dimensional echocardiography in the preoperative assessment of atrioventricular septal defect morphology. Am J Cardiol. Mar 1 2000;85(5):630-5. [Medline].

  17. Marino B, Digilio MC, Toscano A, et al. Congenital heart diseases in children with Noonan syndrome: An expanded cardiac spectrum with high prevalence of atrioventricular canal. J Pediatr. Dec 1999;135(6):703-6. [Medline].

  18. Perloff JK. The Clinical Recognition of Congenital Heart Disease. 4th ed. WB Saunders; 1994:349-80.

  19. Pretre R, Dave H, Kadner A, Bettex D, Turina MI. Direct closure of the septum primum in atrioventricular canal defects. J Thorac Cardiovasc Surg. Jun 2004;127(6):1678-81. [Medline].

  20. Sadler TW. Langman's Medical Embryology. 5th ed. Baltimore, MD: Williams & Wilkins; 1985:176-84.

  21. Snider AR, Serwer GA, Ritter SB. Echocardiography in Pediatric Heart Disease. 2nd ed. Harcourt Health Sciences Group; 1997:277-89.

  22. Zanchetta M, Rigatelli G, Pedon L, et al. Role of intracardiac echocardiography in atrial septal abnormalities. J Interv Cardiol. Feb 2003;16(1):63-77. [Medline].

 
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ECG from a patient with a partial atrioventricular septal defect. The PR interval is mildly prolonged. Left axis deviation with Q waves in leads I and aVL are present, consistent with a counterclockwise loop in the frontal plane. Right atrial enlargement and an rsR' pattern in the right chest leads also are noted.
Two-dimensional, apical, 4-chamber echocardiogram of a partial atrioventricular (AV) canal defect. The asterisk (*) delineates an area of dropout in the inferior atrial septum at the site of the primum atrial septal defect. The AV valves are separate but aligned at the same horizontal level, consistent with a 2-orifice common AV valve. In systole, the medial leaflets of the right- and left-sided AV valves demonstrate attachments to the crest of the interventricular septum, allowing no ventricular level shunting. RA = Right atrium; LA = Left atrium; RV = Right ventricle; LV = Left ventricle.
Gross pathology specimen viewed from the opened left atrium and left ventricle, demonstrating a partial atrioventricular (AV) canal defect. An ostium primum atrial septal defect (ASD) marked by an asterisk (*) is visualized in the inferior aspect of the interatrial septum. An ostium secundum ASD marked by 2 asterisks (**) is also noted. The mitral valve is cleft and the leaflets are thickened and rolled, suggestive of chronic mitral regurgitation. LA = Left atrium; LV = Left ventricle; MV = Mitral valve.
 
 
 
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