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Patent foramen ovale vs atrial septal defect

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Patent foramen ovale vs atrial septal defect

  1. 1. Dr Ahmed Esawy MBBS M.Sc MD PATENT FORAMEN OVALE VS ATRIAL SEPTAL DEFECT
  2. 2. ASD and PFO are different types of interatrial defect Septum primum forms first .it leaves window ,Ostium secundum septum secundum forms later .usually covers Ostium secundum
  3. 3. Foramen ovale intrauterine allow blood to flow From right to left by passing the lung It closes after birth But stays open in 25-28 % of people
  4. 4. If the septum secundum fails to cover the ostium secundum .blood flow in both direction causing atrial septal defect OSD Inferior limb septum primum. superior limb septum primum. superior limb septum secundum. inferior limb septum secundum.
  5. 5. Patent Foramen Ovale An interatrial communication between the superior limb of the septum secundum on the right side the septum primum on the left atrial side .• The flap of the foramen ovale (FO) can often be seen
  6. 6. Foramen ovale is defect in septum secundum Ostium Secundum Atrial Septal Defect Defect in the septum primum.
  7. 7. ASD
  8. 8. ostium primum ostium primum atrial septal defect is a defect in the atrial septum at the level of the tricuspid and mitral valves
  9. 9. ASD and PFO can diagnosed by TEE but not excluded by it No shunt seen by echo not mean that no PFO or small ASD Defect Anterior to FO = primum defect (often w MV cleft) Defect Post/Sup to FO = sinus venosus defects (often w anomalous R pulm vn connection) Ostium Primum Atrial Septal Defect :Located in the most anterior and inferior aspects of the atrial septum. near the atrioventricular valves sinus venosus type ASD, situated near the entry of the SVC or IVC
  10. 10. Indication to close ASD  RV /RA enlarged  QP : QS more than 1.5  Paradoxical embolism
  11. 11. PATENT FORAMEN OVALE ASD OSTIUM Right to left shunt Left to right shunt normal or slightly elevated pulmonary pressure, pulmonary hypertension of different degree, normal Qp/Qs ratio , an increased Qp/Qs ratio normal right chambers enlarged right chambers ostium secundum ASD, placed in the midportion of the septum in the area of the fossa ovalis

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