Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-10T07:38:31.526Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access Rights & Permissions [Opens in a new window]

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
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

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