Eichhorn P, Vogt P, Ritter M, Widmer V, Jenni R
Departement für Innere Medizin, Universitätsspital Zürich.
Schweiz Med Wochenschr. 1995 Jul 11;125(27-28):1336-41.
To classify interatrial septal anomalies in adults, 24,458 Doppler-echocardiographic studies performed between 1. 1. 1987 and 31. 12. 1992 were reviewed. Patients below 16 years of age or with complex congenital heart disease, or after surgical closure of an atrial septal defect, were excluded. Additionally, all 823 transesophageal echocardiographies done between 1. 1. 1993 and 31. 12. 1994 were analyzed to see whether a patent foramen ovale was present. Among 294 patients with interatrial septal anomalies (prevalence 1.2%; male:female = 1:1.4), 298 congenital anomalies of the interatrial septum were detected. 63% of interatrial septal anomalies constituted newly detected anomalies. Age ranged from 16 to 84 (median 43) years. In 21% of the patients the left-to-right shunt was > or = 50% (QP/QS > or = 2). In 25% pulmonary hypertension was present and 25% of the patients underwent surgery. A patent foramen ovale was present in 0.16% of all transthoracal and in 5.7% of all transesophageal echocardiographies. Secundum defects constituted 46%, atrial septal aneurysms 24%, patent foramen ovale 13%, atrioventricular canals 11%, and superior sinus venosus defects with anomalous pulmonary venous return 6% of all diagnoses. Associated anomalies were mitral valve prolapse in 14%, pulmonary valve stenosis in 3%, left-sided persistent vena cava superior and Chiari network in 2% each, anomalous pulmonary venous return, ventricular septal defect, bicuspid aortic valve, and Ebstein's anomaly in 1% each. 4% of the patients showed further cardiac lesions.
Anomalies of the interatrial septum in adults were frequent and often newly detected. In a high percentage of patients with interatrial septum the left-to-right shunt was hemodynamically relevant.
为对成人房间隔异常进行分类，回顾了1987年1月1日至1992年12月31日期间进行的24458例多普勒超声心动图研究。排除16岁以下患者、患有复杂先天性心脏病的患者或房间隔缺损手术闭合后的患者。此外，分析了1993年1月1日至1994年12月31日期间进行的所有823例经食管超声心动图，以确定是否存在卵圆孔未闭。在294例房间隔异常患者中（患病率1.2%；男∶女=1∶l.4），检测到298例先天性房间隔异常。63%的房间隔异常为新发现的异常。年龄范围为16至84岁（中位数43岁）。21%的患者左向右分流≥50%（QP/QS≥2）。存在肺动脉高压的患者占25%，25%的患者接受了手术。所有经胸超声心动图中卵圆孔未闭占0.16%，所有经食管超声心动图中占5.7%。继发孔缺损占所有诊断的46%，房间隔瘤占24%，卵圆孔未闭占13%，房室管占11%，上腔静脉窦缺损伴肺静脉异常回流占6%所有诊断。相关异常包括二尖瓣脱垂占14%，肺动脉瓣狭窄占占二尖瓣脱垂占14%，肺动脉瓣狭窄占3%，左侧永存上腔静脉和奇静脉网各占占二尖瓣脱垂占14%，肺动脉瓣狭窄占3%，左侧永存上腔静脉和奇静脉网各占占二尖瓣脱垂占14%，肺动脉瓣狭窄占3%，左侧永存上腔静脉和奇静脉网各占2%，肺静脉异常回流占二尖瓣脱垂占14%，肺动脉瓣狭窄占3%，左侧永存上腔静脉和奇静脉网各占2%，肺静脉异常回流、室间隔缺损、二叶式主动脉瓣和埃布斯坦畸形各占1%。4%的患者有其他心脏病变。
成人房间隔异常常见，且常为新发现。在高比例的房间隔患者中，左向右分流具有血流动力学意义。
