Closure of secundum atrial septal defect with autologous right atrial patch: case report.
BACKGROUND
Although various synthetic materials and pericardium have been used for atrial septal defect (ASD) closure, investigators are continuing to search for an ideal material for this procedure. We report and evaluate a case in which autologous right atrial wall tissue was used for ASD closure.


METHODS
In this case, we closed a secundum ASD of a 22-year-old woman who also had right atrial enlargement due to the defect. After establishing standard bicaval cannulation and total cardiopulmonary bypass, we opened the right atrium with an oblique incision in a superior position to a standard incision. After examining the secundum ASD, we created a flap on the inferior rim of the atrial wall. A stay suture was stitched between the tip of the flap and the superior rim of the defect, and suturing was continued in a clockwise direction thereafter. Considering the size and shape of the defect, we incised the inferior attachment of the flap, and suturing was completed. Remnants of the flap on the inferior rim were resected, and the right atrium was closed in a similar fashion.


RESULTS
During an echocardiographic examination, neither a residual shunt nor perigraft thrombosis was seen on the interatrial septum. The patient was discharged with complete recovery.


CONCLUSIONS
Autologous right atrial patch is an ideal material for ASD closure, especially in patients having a large right atrium. A complete coaptation was achieved because of the muscular nature of the right atrial tissue and its thickness, which is a closer match to the atrial septum than other materials.
Darçin
Osman Tansel
OT
Department of Cardiovascular Surgery, Harran University, Faculty of Medicine, Sanliurfa, Turkey. otdarcin@hotmail.com
Kunt
Alper Sami
AS
Andac
Mehmet Halit
MH
D000328:Adult; D006332:Cardiomegaly / Q000209:etiology; D002315:Cardiopulmonary Bypass; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000637:transplantation*; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D011184:Postoperative Period; D013524:Surgical Flaps; D013536:Suture Techniques; D014182:Transplantation, Autologous; D016896:Treatment Outcome