The development of open techniques of cardiac surgery utilizing a pump-oxygenator permits closure of atrial septal defects by use of this method. It has been advocated by some investigators that techniques previously used successfully be abandoned in favor of it. One of the reasons given for this view is the assertion that the diagnosis of atrial septal defect of the usual type cannot be made accurately before operation, and, therefore, operation with extracorporeal circulation is necessary to permit the surgeon to treat any unanticipated lesions encountered.1
Although an efficient pump-oxygenator permitting open-heart operations has been in use at the Mayo Clinic2 since 1955, we have continued to employ the atrial-well technique for most patients in whom a diagnosis of atrial septal defect is made.3 Should the incidence of diagnostic error be significant, a disservice would be done to these patients by attempting to avoid the more extensive
SILVER AW, KIRKLIN JW. Accuracy of Diagnosis in Surgical Cases of Atrial Septal Defect. AMA Arch Surg. 1960;80(2):241–243. doi:10.1001/archsurg.1960.01290190061012
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