Tak Tahir, Khurana Anand, Dhawan Sumeesh
Department of Cardiology, Marshfield Clinic, Marshfield, WI 54449, USA.
WMJ. 2005 Apr;104(3):45-8.
Atrial septal defects are among the most common congenital heart defects seen in the adult population. The diagnosis is usually made in children and closure is attempted before they are school age. In other cases, where the diagnosis is missed until adulthood, atrial arrhythmias and congestive heart failure are commonly seen. We report the case of an atrial septal defect (secundum type), which was diagnosed in a 72-year-old woman with paroxysmal atrial fibrillation. She also had a history of hypertension and hyperlipidemia. Transthoracic and transesophageal findings were consistent with right-sided volume overload and an atrial septal defect of approximately 1 cm in size. This was corroborated by the findings on cardiac catheterization with a shunt ratio of 1.8. The pulmonary artery pressures were within normal limits. The patient was referred for closure of the atrial septal defect. Presently, the options for septal defect closure are direct suture repair, Dacron patch repair depending on the size of the defect, and percutaneous transcatheter closure. Transcatheter closure is also available in treating selected patients with patent foramen ovale.
房间隔缺损是成人中最常见的先天性心脏病之一。通常在儿童期确诊，并在他们上学前尝试进行封堵。在其他情况下，直到成年才被漏诊，常出现房性心律失常和充血性心力衰竭。我们报告一例继发孔型房间隔缺损病例，该病例在一名72岁阵发性心房颤动女性中被诊断出来。她还有高血压和高脂血症病史。经胸和经食管检查结果与右侧容量负荷过重以及大小约为1厘米的房间隔缺损相符。心导管检查结果证实了这一点，分流比为1.8。肺动脉压力在正常范围内。该患者被转诊进行房间隔缺损封堵。目前，房间隔缺损封堵的选择包括直接缝合修复、根据缺损大小进行涤纶补片修复以及经皮导管封堵。经导管封堵也可用于治疗部分卵圆孔未闭患者。
