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November 1966

Hemodynamics in Acute Atrial Septal DefectThe Influence of Supravalvular Stenosis on Shunt Magnitude

Author Affiliations

From the Department of Surgery, The Johns Hopkins University School of Medicine. Dr. Weldon is a John and Mary R. Markle Scholar in Academic Medicine.

Arch Surg. 1966;93(5):724-729. doi:10.1001/archsurg.1966.01330050028004

HEMODYNAMIC relationships which establish the magnitude and direction of blood flow across defects in the atrial septum have been previously investigated. Early investigators1-3 attributed the left to right shunting of blood to pressure gradients between the left and right atria. Barger and associates4 in 1948 suggested that the larger opening of the tricuspid valve and the ease with which the right ventricle fills diminishes the resistance to blood flow into the right side of the heart. Hull5 maintained that the shape of the right ventricle permits it to fill more readily than the left ventricle. Dexter,6 in an analysis of hemodynamics in 60 patients with atrial septal defects, pointed out that when the atrial septal defect is small the pressure difference between atria is usually not greater than 3 mm and that when the atrial defect is large the two atria function as a common chamber

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