Atrial Septal Defect: Anatomoechocardiographic Correlation

This study was undertaken to enhance understanding of the anatomic abnormalities involved in atrial septal defect (ASD) based on the anatomoechocardiographic comparison of equivalent specimens of ASD and the echocardiograms of patients with this anomaly. Of the 72 heart specimens, two had common atrioventricular canal (2.8%) and one had absence of right atrioventricular connection (1.4%). In all, 46 (63.8%) had fossa ovalis type ASD, two (2.8%) had true ostium secundum type ASD, two (2.8%) had ostium primum type ASD, two (2.8%) had superior sinus venosus type ASD, and two (2.8%) had inferior sinus venosus type ASD. One (1.4%) specimen had a coronary venous sinus type ASD and 14 (19.4%) had mixed type ASD. Of the 144 patients evaluated with echocardiography 15 (10.4%) had common atrioventricular canal, one (0.7%) had right absence of atrioventricular connection, 105 (72.9%) had ostium secundum type ASD (fossa ovalis), 10 (7%) had mixed type ASD, 9 (6.2%) had superior venous sinus type ASD, two (1.4%) had ostium primum type ASD, and two (1.4%) had true fossa ovalis type ASD. This series leads us to conclude that the key to successful management of ASD depends on understanding echocardiographic images in terms of anatomic specimens to provide appropriate evaluations for therapeutic decisions and establishment of prognoses.