J.Jpn. Surg. Soc.. 57(1): 47-68, 1956

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ATRIAL SEPTAL DEFECT FORMATION AGAINST MITRAL STENOSIS AND MITRAL INSUFFICIENCY (ON THE OPTIMAL SIZE OF ATRIAL SEPTAL DEFECT)

The author has produed mitral stenosis (MS) and mitral insufficiency (MI) combined wilh atrial septal defect (ASD) of various sizes in mongrel dog weighing 8 to 10 kilograms.
Experimental dogs were observed over a proIonged period.
Cardiac catheterization and liver function were examined during life, and autopsy and histological findings were also examined in detail. It was found that atriaI septaI defects of 20 to 60 mm² in size were optimal from the follwing points.
I) The dogs with a high degree of MS combined with ASD died early after operation, but those with the optimal size survived for the longest time. Animals with a medium degree of MS and MI combined with various sizes of ASD all survived for a long time but the optimal ones showed the most excellent clinical results.
II) From autopsy and histological findings, experimental dogs with small ASD (below 20mm²) showed congestion in the lesser circulaatory system. On the contrary, the animals with large ASD (over 60mm²) showed engorgement in the systemic organs. Ascites was found in some. Both sytems were relatively intact in the optimaal case.
III) Cardiac catheterization showed that too large an ASD caused over atrain of both systemic circulation and right heart.
IV) Liver function: The animal with a large asd tends to show marked disturbance of discharge and in the parenchyma, but these were relativeIy minimal in the optimal case.
(author's abstract)

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