A Case of Residual Atrial Septal Defect with Left Atrial Isomerism Requiring Reoperation 37 Years after the First Operation

Yuki Ogata＊	Hideaki Kanda＊	Tomoyuki Matsuba＊
Yushi Yamashita＊	Shuji Nagatomi＊	Naoki Tateishi＊
Keisuke Kawaida＊	Kenji Toyokawa＊	Itsumi Imagama＊
Yutaka Imoto＊

（Cardiovascular and Gastrointestinal Surgery, Kagoshima University Graduate School of Medical and Dental Sciences＊, Kagoshima, Japan）

A 47-year-old female was admitted to our hospital for management of dyspnea. She had undergone surgery for an atrial septal defect（ASD）at the age of 17. Computed tomography revealed left isomerism, inferior vena cava interruption with azygos continuation and a residual ASD. Intra-operative findings showed that the residual ASD was positioned across the orifice of the hepatic vein. The previous suture line could be identified in the partially-closed atrial septum above the residual defect. Re-closure was performed without difficulties, and the patient’s condition was good at discharge. Closure of ASD is a simple and basic procedure in cardiac surgery but care must be taken not to leave a shunt at the lower part of the defect, especially in cases with ASD defects in the lower margin.
　　

Jpn. J. Cardiovasc. Surg. 48:313-315（2019）

Keywords：adult congenital heart disease;atrial septal defect;left atrial isomerism;residual shunt;reoperation