PMC8238532_01
Preoperative TTE showed (
A
) an ostium primum ASD and PFO, and (
B
) severe left-sided atrioventricular valve insufficiency. Postoperative TEE confirmed an intact septum without residual shunt (
C
) and trace mitral insufficiency (D) after surgery. ASD, atrial septal defect; LA, left atrium; LV, left ventricle; PFO, patent foramen ovale; RA, right atrium; TTE, transesophageal echocardiography.
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Echocardiography demonstrated a large ostium primum atrial septal defect (2.1 cm) with significant shunt, cleft left atrioventricular valve with severe insufficiency, patent foramen ovale (PFO) ( Fig. 1A, B ), and moderate tricuspid regurgitation with an ejection fraction of 66%. Postoperative echocardiography demonstrated no residual shunt and trace mitral insufficiency ( Fig. 1C, D ).
(
A
) Cleft between the left superior and inferior leaflets (black arrow) was examined and repaired through the ostium primum ASD (red arrow) and the incised septum primum (yellow arrow). (
B
) Saline test showed a competent mitral valve after the repair. (
C
) An autologous pericardial patch was use to repair the ostium primum ASD. (
D
) Postoperative appearance of the patient's chest. ASD, atrial septal defect.
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Prolene suture, and the ostium primum defect was repaired with the use of an autologous pericardial patch ( Fig. 2 ). PFO was closed with a horizontal mattress pledgeted 4/0 Prolene suture.