[Left ventricle-right atrial communication. Surgical, hemodynamic and clinical aspects (author's transl)]

Anatomical, clinical radiographic and electrocardiographic aspects in 12 cases of left ventricle-right atrial communication are described. The usual severity and precocity of symptoms are outlined. At cardiac catheterization the level of the shunt was not found to be exactly correlated with the anatomic type of the defect; the mean QP/QS was 2,7 (1,4-5,8); only one case of pulmonary hypertension was detected and the mean RP/RS was 0,19 (0,06-0,83). Contrastographic aspects are emphasized and the importance of having two orthogonal projections is outlined. 9 patients underwent surgical repair with good results, except for the patient with pulmonary hypertension, who died soon after the operation: this patient shouldn't have been operated on. In all cases only right atriotomy was made, and the defect was closed by a dacron patch; no patient had a tricuspid plastic; one perforation and one cleft of the septal leaflet of the tricuspid valve were sutured directly. In view of the simplicity of surgical correction, wide indications are possible, considering, too, that there have been no reports on the spontaneous closure of the defect.