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The anatomy of interatrial communications - what does the interventionist need to know?

Martins, JDF; Anderson, RH; (2000) The anatomy of interatrial communications - what does the interventionist need to know? Cardiology in the Young , 10 (5) 464 - 473. 10.1017/S1047951100008155. Green open access

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Abstract

Increasingly, the interventional cardiologist is seeking to close interatrial communications by inserting devices by means of catheterisation. So as to optimise these procedures, it is adavantageous to have a firm grasp of the anatomy of the normal atrial septal structures, this then providing the basis to understand the morphology of the holes which can exist between the chambers, not all of which are true septal defects.A true septal structure can be removed without exiting from the cavities of the heart. It is the flap valve of the oval fossa, along with the anterior rim of the fossa, which fulfill this criterion. The remainder of the extensive rim of the normal fossa is no more than an infolding between the walls of the right and left atriums and their venous tributaries, and has different dimensions at various points around the ircumference. The so-called muscular atrioventricular “septum” is a sandwich incorporating a layer of epicardial fibro-adipose tissue. True defects of the atrial septum, therefore, exist because of deficiency, perforation, or absence of the flap valve. Most of these defects will prove suitable for interventional closure, but potential caveats include multiple defects, aneurysm of the flap valve, or adjacency of the fossa to the venous orifices. The other interatrial communications, namely the sinus venosus, coronary sinus, and “ostium primum” defects are outside the confines of the oval fossa. Recognition of this feature is the key to their diagnosis, and their ifferentiation from true atrial septal defects. Of these defects, only the coronary sinus defect is likely to be suitable for device closure, and then only in the very rare circumstances when it is seen in isolation

Type: Article
Title: The anatomy of interatrial communications - what does the interventionist need to know?
Open access status: An open access version is available from UCL Discovery
DOI: 10.1017/S1047951100008155
Publisher version: http://dx.doi.org/10.1017/S1047951100008155
Language: English
Additional information: J SEP 359ZA CARDIOL YOUNG © Greenwich Medical Media Ltd.
Keywords: communication, Young, Atrial septum, atrial septal defect, oval fossa defect, sinus venosus defect, coranary sinus defect, ostium primum defect
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
URI: https://discovery.ucl.ac.uk/id/eprint/74120
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