Author + information
- Received November 15, 2010
- Accepted November 19, 2010
- Published online July 26, 2011.
A 62-year-old man presented with symptoms and signs of right-sided heart failure. Echocardiography revealed severe right-heart dilation and moderate pulmonary artery hypertension (pulmonary artery systolic pressure 55 mm Hg). Transesophageal echocardiography demonstrated both a sinus venosus atrial septal defect and a secundum atrial septal defect (A, B, Online Videos 1 and 2), with a predominant left-to-right shunt and a brief right-to-left shunt (C, Online Videos 3 and 4). Also, the right superior pulmonary vein was found to be anomalously draining into the superior vena cava (broken ring sign) (D, Online Video 5). The patient underwent successful surgical repair of the defects and also an atrial fibrillation ablation procedure.
Mixed defects account for only 7% of all atrial septal defects. The normal interatrial septum can be anatomically divided into 5 septal zones. Any defect involving 2 or more of the atrial septal zones is termed a mixed defect.
- Received November 15, 2010.
- Accepted November 19, 2010.
- American College of Cardiology Foundation