By Donald N. Ross B. Sc., M. B., CH. B., F. R. C. S. (auth.)
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Extra resources for A Surgeons’ Guide to Cardiac Diagnosis: Part II The Clinical Picture
4). The septum primum develops first but with a deficiency below forming the ostium primum. A thicker septum secundum then develops on its right side. This has an c a b Fig. 28. a Types of atrial Aeptal defect - ostium primum. b The usual ostium secundum type of atrial septal defect. c The sin us venosus type of atrial septal defect 46 Atrial Septal Defect oval deficiency posteriorly which is floored by the septum primum and forms the fossa ovalis. A small hole (ostium secundum) appears at this stage in the septum primum to form with the fossa ovalis the valvular foramen ovale which functions until birth.
In ductus arteriosus the main pulmonary artery is prominent. Rupture of a sinus of valsalva into the right atrium or right ventricle gives a collapsing type of pulse and is usually associated with a continuous murmur. A history of sudden onset of cardiac failure is a helpful feature but the physical signs may be very difficult to distinguish from ductus. ent Ductus Arteriosus retrograde aortography are necessary to establish the diagnosis and precise anatomy. Persistent ductus may be responsible for a collapsing pulse and a pronounced arterial pulsation in the supra-sterwil notch.
19. Demonstration of residual functional obstructive gradient after pulmonary valvotomy in Fallot's tetralogy, but represents a diffuse hypertrophy of the muscle of the outflow tract, as part of the general right ventricular hypertrophy. In addition, this muscular channel contracts with systole and constitutes a serious obstruction to the ejection of blood from the right ventricle. An analogous state of affairs can be demonstrated in the left ventricle (p. 37 and 72). The surgical management of this functional obstruction has developed from an understanding of the mechanism of its production and, latterly, from the observation that many of these obstructions will disappear with regression of the right ventricular hypertrophy.
A Surgeons’ Guide to Cardiac Diagnosis: Part II The Clinical Picture by Donald N. Ross B. Sc., M. B., CH. B., F. R. C. S. (auth.)