Closure of Secundum Atrial Septal Defect with Autologous Right Atrial Patch: Case Report

Authors

  • Osman Tansel Darçin
  • Alper Sami Kunt
  • Mehmet Halit Andac

DOI:

https://doi.org/10.1532/HSF98.20041173

Abstract

Background: Although various synthetic materials and pericardium have been used for atrial septal defect (ASD) closure, investigators are continuing to search for an ideal material for this procedure. We report and evaluate a case in which autologous right atrial wall tissue was used for ASD closure.

Case: In this case, we closed a secundum ASD of a 22-year-old woman who also had right atrial enlargement due to the defect. After establishing standard bicaval cannulation and total cardiopulmonary bypass, we opened the right atrium with an oblique incision in a superior position to a standard incision. After examining the secundum ASD, we created a flap on the inferior rim of the atrial wall. A stay suture was stitched between the tip of the flap and the superior rim of the defect, and suturing was continued in a clockwise direction thereafter. Considering the size and shape of the defect, we incised the inferior attachment of the flap, and suturing was completed. Remnants of the flap on the inferior rim were resected, and the right atrium was closed in a similar fashion.

Results: During an echocardiographic examination, neither a residual shunt nor perigraft thrombosis was seen on the interatrial septum. The patient was discharged with complete recovery.

Conclusion: Autologous right atrial patch is an ideal material for ASD closure, especially in patients having a large right atrium. A complete coaptation was achieved because of the muscular nature of the right atrial tissue and its thickness, which is a closer match to the atrial septum than other materials.

References

Alehan D, Dogan R, Ozkutlu S, et al. 2001. Severe hemolytic anemia after repair of primum septal defect and cleft mitral valve. Turk J Pediatr 43:329-31.nPreventza O, Sampath-Kumar S, Wasnick J, et al. 2004. Late cardiac perforation following transcatheter artial septal defect closure. Ann Thorac Surg 77:1435-7.nKumar AS, Choudhary SK, Ray R, et al. 2002. Autologous right atrial patch for closure of atrial septal defect. Indian Heart J 54:289-91.nDoll N, Walther T, Falk V, et al. 2003. Secundum ASD closure using a right lateral minithoracotomy: five-year experience in 122 patients. Ann Thorac Surg 75:1527-30.nLevinson ML, Fonger J. 1998. Minimally invasive atrial septal defect closure using the subxyphoid approach. Heart Surg Forum 1(1):49-53.nJemielity M, Perek B, Paluszkiewicz L, et al. 2001. Results of surgical repair of ostium primum atrial septal defect in adult patients. J Heart Valve Dis 10:525-9.nKouchoukos NT, Blackstone EH, Doty DB, et al. 2003. Atrial septal defect and partial anomalous pulmonary venous connection. In: Kouchoukos NT, Blackstone EH, Doty DB, Hanley FL, Karp RB, editors. Cardiac surgery. 3rd ed. Philadelphia: Churchill Livingston. p 715-51.nBerdat PA, Chatterjee T, Pfammatter JP, et al. 2000. Surgical management of complications after transcatheter closure of an atrial septal defector patent foramen ovale. J Thorac Cardiovasc Surg 120:1034-9.nHan YM, Gu X, Titus JL, et al. 1999. New self-expanding patent foramen ovale occlusion device. Catheter Cardiovasc Interv 47:370-6.n

Published

2005-03-09

How to Cite

Darçin, O. T., Kunt, A. S., & Andac, M. H. (2005). Closure of Secundum Atrial Septal Defect with Autologous Right Atrial Patch: Case Report. The Heart Surgery Forum, 8(2), E96-E97. https://doi.org/10.1532/HSF98.20041173

Issue

Section

Articles