Ostium Primum Defect: Factors Causing Deterioration in the Natural History

The anatomy of the ostium primum atrial septal defect has been known since Rokitansky's description in 1875. However, until the introduction of cardiac catheterization and open heart surgery, information about the physiology and clinical features of this condition lagged behind knowledge of the morbid anatomy. Attempts at surgical correction have influenced the natural history, and information about the prognosis of the untreated ostium primum atrial septal defect, at present scanty, is unlikely to increase as the scope of cardiac surgery widens. The factors present in severely disabled patients with an ostium primum defect and those who died without surgery have been studied in order to discover causes of spontaneous deterioration.