Sinus Venosus Atrial Septal Defect

Abstract

Background— Sinus venosus atrial septal defect (SVASD) differs from secundum atrial septal defect by its atrial septal location and its association with anomalous pulmonary venous connection (APVC). Data on long-term outcome after surgical repair are limited. Methods and Results— We reviewed outcomes of 115 patients (mean age±SD 34±23 years) with SVASD who had repair from 1972 through 1996. APVC was present in 112 patients (97%). Early mortality was 0.9%. Complete follow-up was obtained for 108 patients (95%) at 144±99 months. Symptomatic improvement was noted in 83 patients (77%), and deterioration was noted in 17 patients (16%). At follow-up, 7 (6%) of 108 patients had sinus node dysfunction, a permanent pacemaker, or both, and 15 (14%) of 108 patients had atrial fibrillation. Older age at repair was predictive of postoperative atrial fibrillation ( P =0.033). No reoperations were required during follow-up. Survival was not different from expected for an age- and sex-matched population. Clinical improvement was more common with older age at surgery ( P =0.014). Older age at repair ( P =0.008) and preoperative New York Heart Association class III or IV ( P =0.038) were independent predictors of late mortality. Conclusions— Operation for SVASD is associated with low morbidity and mortality, and postoperative subjective clinical improvement occurs irrespective of age at surgery. Postoperative atrial fibrillation appears to be related to older age at operation. SVASD repair achieves survival similar to that of a matched population and should be considered whenever repair may impact survival or symptoms.

Atrial Septal Defects in the Adult

“…Inverted P waves in the inferior leads suggest an absent or deficient sinus node, as may be seen in a sinus venosus defect. 16,17 Right atrial overload is often present. First-degree heart block suggests a primum ASD 18 but may be seen in older patients with a secundum ASD.…”

Sinus Venosus-Type Atrial Septal Defect

“…A TEE performed by specialists in cardiac malformations may be useful to discover and cure this rare disease because surgical repair may be of significant benefit. 2,9 ECG gated multislice CT appears to be a promising tool in exploring cardiac morphological abnormalities and has been described recently in a case of SVD as a supplement to echocardiography. 10 …”

Comprehensive echocardiographic diagnosis of right heart enlargement in association with partial anomalous pulmonary venous drainage in three adult women

“…This is important to identify because during surgical correction, in addition to the repair of the defect, it is important to redirect the anomalous venous flow to the left atrium. 3 For the same reason, these defects are unsuitable for percutaneous device closure.…”