Sinus venosus versus ostium secundum atrial septal defects: Their diagnosis and surgical outcome

Abstract

Background: Diagnosis of sinus venosus atrial septal defects (ASDs) poses clinical difficulties than that of ostium secundum ASDs which may delay its diagnosis and treatment. Surgical repair of sinus venosus ASDs is more intricate in correlation with the repair of ostium secundum ASDs and conveys the risk of stenosis of the superior vena cava (SVC) or the rerouted pulmonary veins (PVs) and sinus node dysfunction (SND). Objectives: To compare diagnostic modalities and surgical outcome of sinus venosus ASDs to that of ostium secundum ASDs. Patients and Methods: Out of the total 72 patients in the age range of 1 year–46 years, 36 patients underwent surgical repair of sinus venosus ASDs and 36 patients underwent surgical repair of ostium secundum ASDs. Their data were collected and retrospectively studied from June 1, 2009, to October 1, 2016, at Ibn-Alnafees Teaching Hospital for cardiothoracic surgery in Baghdad, Iraq. We divided the patients into two groups: Group A including 36 patients who had sinus venosus ASDs and Group B including 36 patients who had ostium secundum ASDs. A comparison was made between the two groups according to preoperative variables, diagnostic modalities, intraoperative variables, and postoperative morbidity and mortality. Results: Transthoracic echocardiography (TTE) was the mainstay for the diagnosis of ASD secundum, while ASD venosus type needed more modalities for diagnosis. No operative death, postoperative bleeding, acute renal failure, SND, SVC stenosis, and PV stenosis were observed in any patient in the two groups. Residual shunt was not observed in any case in the two groups. Conclusion: TTE, transesophageal echocardiography, cardiac magnetic resonance imaging, or diagnostic catheterization may be needed for the diagnosis of sinus venosus ASD. Surgery is the mainstay of sinus venosus ASDs with low morbidity and no mortality, similar to ostium secundum ASDs.