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Leftward deviation of the primary septum or dividing left atrial shelf?

Part of: Cardiac Morphology

Published online by Cambridge University Press:  09 November 2021

Jelena Hubrechts Open the ORCID record for Jelena Hubrechts [Opens in a new window] ,
Julie Pollenus  and
Marc Gewillig
Jelena Hubrechts*
Affiliation:
Department of Congenital and Pediatric Cardiology, University Hospital Saint-Luc, Brussels, Belgium
Julie Pollenus
Affiliation:
Department of Pediatrics, University Hospital Leuven, Leuven, Belgium
Marc Gewillig
Affiliation:
Department of Congenital and Pediatric Cardiology, University Hospital Leuven, Leuven, Belgium
*
Author for correspondence: J. Hubrechts, MD, Pediatric and Congenital Cardiology, University Hospital Saint-Luc, Avenue Hippocrate 10, Brussels B-1200, Belgium. Tel: +32 2 764 16 59. Fax: +32 2 764 89 11. E-mail: jelena.hubrechts@uclouvain.be
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Abstract

Isolated leftward prolapse or deviation of the primary atrial septum is a rare CHD that can mimic abnormal pulmonary venous return at first sight. We present a case of a newborn infant, referred for surgical correction of totally anomalous pulmonary venous return into the right atrium, with the peri-operative finding of a leftward deviation of the superior margin of the primary atrial septum. The distinction with a dividing atrial shelf could not be confirmed with certainty. Fifty-three similar cases from the literature are incorporated. A detailed review of the current account on atrial septation is studied. The embryological and clinical features of a dividing partition of the left atrium are discussed.

Keywords

Primary septumdeviationdivided left atriumatrial septal development
Type
Review
Information
Cardiology in the Young , Volume 31 , Issue 12 , December 2021 , pp. 1893 - 1900
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Van Praagh, S, Carrera, ME, Sanders, S, Mayer, JE, Van Praagh, R. Partial or total direct pulmonary venous drainage to right atrium due to malposition of primary septum: anatomic and echocardiographic findings and surgical treatment: a study based on 36 cases. Chest 1995; 107: 1488–1498.CrossRefGoogle ScholarPubMed
Cuttone, F, Hadeed, K, Lacour-Gayet, F, et al. Isolated severe leftward displacement of the primary septum: anatomic and 3D echocardiographic findings and surgical repair. Interact Cardiovasc Thorac Surg 2017; 24: 772–777.CrossRefGoogle Scholar
Chin, AJ, Weinberg, PM, Barber, G. Subcostal two-dimensional echocardiographic identification of anomalous attachment of primary septum in patients with left atrioventricular valve underdevelopment. J Am Coll Cardiol 1990; 15: 678–681.10.1016/0735-1097(90)90645-6CrossRefGoogle Scholar
Park, MV, Fedderly, RT, Frommelt, PC, et al. Leftward displacement of primary septum in hypoplastic left heart syndrome. Pediatr Cardiol 2013; 34: 942–947.CrossRefGoogle Scholar
Silvestri, LM, Scarabotti, A, Marino, B. Leftward displacement of primary septum in children with congenital heart disease. Pediatr Cardiol 2014; 35: 185.CrossRefGoogle Scholar
Anderson, RH, Brown, N, Mohun, T. Embryology of the heart. In: Wernovsky, G, Anderson, RH, Krishna, K, et al. (eds). Anderson’s Pediatric Cardiology, 4th edn. Elsevier, Philadelphia, 2020: 33–48.Google Scholar
Jensen, B, Spicer, DE, Sheppard, MN, Anderson, RH. Development of the atrial septum in relation to postnatal anatomy and interatrial communications. Heart 2016; 103: 1–7.Google ScholarPubMed
Ayylldlz, P, Öztürk, E, Kasar, T, Türkvatan, A, Onan, IS, Güzeltaş, A. A rare cause of abnormal pulmonary venous drainage: primary septum malposition. Cardiol Young 2020; 30: 1716–1721.Google Scholar
Anderson, RH, Spicer, D, Redington, AN. Division of atrial chambers (“Cor Triatriatum”). In: Wernovsky, G, Anderson, RH, Krishna, K, et al. (eds). Anderson’s Pediatric Cardiology, 4th edn. Elsevier, Philadelphia, 2020: 517–520.Google Scholar
Van Praagh, R, Corsini, I. Cor triatriatum: pathologic anatomy and a consideration of morphogenesis based on 13 postmortem cases and a study of normal development of the pulmonary vein and atrial septum in 83 human embryos. Am Heart J 1969; 78: 379–405.CrossRefGoogle Scholar
Hiramatsu, T, Takanashi, Y, Imai, Y, et al. Atrial septal displacement for repair of anomalous pulmonary venous return into the right atrium. Ann Thorac Surg 1998; 65: 1110–1114.10.1016/S0003-4975(97)01419-7CrossRefGoogle ScholarPubMed
Turley, K, Tarnoff, H, Snider, R, Ebert, PA. Repair of combined totally anomalous pulmonary venous connection and anomalous systemic connection in early infancy. Ann Thorac Surg 1981; 31: 70–77.CrossRefGoogle Scholar
Jhaveri, S, Erenberg, F, Yaman, M. Rare case of primary septum malposition defect in dextrocardia and situs inversus totalis without heterotaxy syndrome. Cardiol Young 2019; 29: 419–421.CrossRefGoogle Scholar
Prasad, D, Snyder, C, Ashwath, R. Primary septum malposition defect and inferior sinus venosus defect: a rare association. Cardiol Young 2014; 25: 1389–1392.CrossRefGoogle Scholar
Atik, E, Cassar, RS, Morhy, SS, Andrade, JL. Totally anomalous pulmonary venous connection and a restrictive oval fossa, with left-sided deviation of the atrial septum mimicking left-sided divided left atrium: echocardiographic misdiagnosis. Arq Bras Cardiol 2006; 87: e263.CrossRefGoogle Scholar
Tomar, M, Radhakrishnan, S, Shrivastava, S. Partial or totally anomalous pulmonary venous drainage caused by malposition of primary septum: echocardiographic description of a rare variant of anomalous pulmonary venous drainage. J Am Soc Echocardiogr 2005; 18: 884.CrossRefGoogle ScholarPubMed
Cohen, MS, Weinberg, P, Coon, PD, Gaynor, JW, Rychik, J. Deviation of atrial primary septum in association with normal left atrioventricular valve size. J Am Soc Echocardiogr 2001; 14: 732–737.CrossRefGoogle Scholar