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Factors associated with development of atrial septal restriction in patients with tricuspid atresia involving the right-sided atrioventricular valve.

Abstract：

BACKGROUND:Clinical practice is discrepant regarding routine enlargement of the interatrial communication (IAC) in patients with right-sided atrioventricular valve atresia. We determined the percentage and risk factors of those who develop a restrictive IAC. METHODS:Medical records were reviewed for patients treated from 1985 to 2006, including those admitted in the first 6 weeks of life (group A), and those referred at a later age (group B), some of whom had routine atrial septal procedures. In group A, we analyzed the initial postnatal echocardiogram. RESULTS:Group A consisted of 79 patients, 16 of whom had an atrial septectomy as part of the initial surgical procedure. Of the remaining 63 patients, 9 (14%) developed atrial septal restriction. In group A, an atrial septal aneurysm (ASA) (OR 16, P = .006) and IAC diameter < 5 mm (OR 13, P = .009) were associated with atrial septal restriction. Atrial septal restriction occurred in 80% of patients with both features, 20% with IAC > or = 5 mm and ASA, 18% with IAC < 5 mm and no ASA, and 2% with neither feature. Group B consisted of 95 patients, 27 of whom had an atrial septal procedure. Of the remaining 68 patients, 11 (16%) developed atrial septal restriction. CONCLUSION:Routine enlargement of the IAC is not necessary in patients with right-sided atrioventricular valve atresia. Patients with ASA or IAC < 5 mm are at increased risk for development of atrial septal restriction.

journal_name

Am Heart J

journal_title

American heart journal

authors

Tzifa A,Gauvreau K,Geggel RL

doi

10.1016/j.ahj.2007.07.037

subject

Has Abstract

pub_date

2007-12-01 00:00:00

pages

1235-41

issue

6

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(07)00621-7

journal_volume

154

pub_type

杂志文章

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