Atrial septal defects
Atrial septal defects
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DOI：
10.1016/s0140-6736(13)62145-5
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发表时间：
2014-05-31
期刊：
影响因子：
168.9
通讯作者：
Wald, Rachel M.
中科院分区：
文献类型：
--
作者：
Geva, Tal;Martins, Jose D.;Wald, Rachel M.
房间隔缺损是第三种最常见的先天性心脏病。在这组畸形中包括几种类型的心房通讯，它允许血液在体循环和肺循环之间分流。大多数患有孤立性房间隔缺损的儿童没有症状，但运动不耐受、房性心动过速、右心室功能障碍和肺动脉高压的发生率随着年龄的增长而增加，而未经治疗的房间隔缺损成人的预期寿命则缩短。发生肺血管疾病（一种潜在的致命并发症）的风险在女性患者和未治疗缺陷的老年人中更高。手术关闭是安全有效的，如果在25岁之前完成，与正常预期寿命有关。经导管闭合为满足解剖和大小标准的患者提供了一种侵入性较小的选择。在这次研讨会上，我们回顾了房间隔缺损的原因，解剖，病理生理，治疗和结果在儿童和成人患者中，这种缺损是主要的心脏异常。
Atrial septal defects are the third most common type of congenital heart disease. Included in this group of malformations are several types of atrial communications that allow shunting of blood between the systemic and the pulmonary circulations. Most children with isolated atrial septal defects are free of symptoms, but the rates of exercise intolerance, atrial tachyarrhythmias, right ventricular dysfunction, and pulmonary hypertension increase with advancing age and life expectancy is reduced in adults with untreated defects. The risk of development of pulmonary vascular disease, a potentially lethal complication, is higher in female patients and in older adults with untreated defects. Surgical closure is safe and effective and when done before age 25 years is associated with normal life expectancy. Transcatheter closure offers a less invasive alternative for patients with a secundum defect who fulfil anatomical and size criteria. In this Seminar we review the causes, anatomy, pathophysiology, treatment, and outcomes of atrial septal defects in children and adult patients in whom this defect is the primary cardiac anomaly.