[Association of an interauricular communication of the sinus venosus type with obstructive myocardiopathy. Surgical treatment].

The authors report the case of a 46 year old man in congestive cardiac failure for 4 years due to the association of a sinus venosus atrial septal defect and hypertrophic obstructive cardiomyopathy. Surgery was attempted because of the poor response to medical therapy. The operation consisted in a trans aortic left ventricular myotomy with mitral valve replacement, enlargement of the atrial septum by a patch and correction of the sinus venosus also by a patch. The result was excellent, with regression of the clinical signs of cardiac failure, maintained after 6 months' follow-up. This is certainly a very rare pathological association of which we were unable to find any previous reported case in the literature. Two cases of ostium secundum atrial septal defect with hypertrophic obstructive cardiomyopathy have been operated on previously, one successfully and the other one without success. A rational surgical approach is suggested, based on the analysis of the physiopathological consequences of this rare association.