Modern advances in interatrial communication in congenital heart defects


This article was originally published here

J Card Surg. November 29, 2021. doi: 10.1111 / jocs.16166. Online ahead of print.


BACKGROUND: Interatrial communication, one of the most frequent congenital heart diseases, represents an important intracardiac shunt between the systemic and pulmonary circulations. The direction and amplitude of the interatrial shunt depends on several characteristics, including the size, shape and location of the defect, the pressure difference between the right and left atrium, and the difference in right and left ventricular compliance.

METHODS: In this review article, the presence or absence of interatrial communication and its role were analyzed, as they may have a critical impact on cardiovascular pathophysiology, and interatrial communication may prove to be either clinically harmful, useful or essential. . As a result, the usefulness and role of interatrial communication in modern congenital, pediatric and adult diseases have evolved, with the indications being modified to close, maintain patency, or create interatrial communication.

RESULTS: Inter-atrial communication and the shunt can be manipulated to maximize oxygen delivery to tissues, depending on the underlying congenital heart defect. While not always relevant for patients with biventricular circulation, it becomes extremely important in children and adults with complex congenital heart defects.

CONCLUSIONS: With improving long-term survival for the vast majority of congenital heart patients, an advanced understanding of the role and utility of interatrial communication, and all the possibilities for its manipulation, is essential to improve outcomes. patient outcomes.

PMID:34842296 | DO I:10.1111 / jocs.16166