Atrial septal defect sinus venosus
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Atrial Septal Defect Microchapters | |
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Surgery | |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3] Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [4]
Overview
During fetal development, the septal wall may fail to fuse causing an atrial septal defect to arise. A sinus venosus atrial septal defect is one such type of malformation arising from the irregular development of the septum and the superior vena cava or the inferior vena cava.
Sinus Venosus Septal Defect
1) Sinus venosus ASD is commonly found to be associated with partial anomalous pulmonary venous return.
2) In presence of partial anomalous pulmonary venous return (pulmonary veins draining into the right atrium instead of the left atrium), atrial septal defect should be corrected by placement of patch over the defect. In larger defects, it is essential to ensure the usage of a synthetic patch to be placed strategically, to allow anomalous pulmonary venous drainage, to be diverted to the left atrium.
3) In this case, anomalous pulmonary venous drainage must be carefully monitored and assessed as compromise of pulmonary venous return due to redirection could lead to pulmonary venous hypertension
Natural History, Compications and Prognosis
1) Good post-surgical prognosis irrespective of the patient's age at surgery.
2) Surgery for sinus venosus ASD is complex compared to other atrial septal defect and can cause stenosis of the superior vena cava or pulmonary veins, residual shunting and SA node dysfunction.