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assume a prim appearance; "They mince and prim"
dress primly (同)prim up, prim out
contract ones lips; "She primmed her lips after every bite of food"

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/08/23 07:40:52」(JST)

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In the developing heart, the atria initially communicate with each other by an opening between the free edge of the septum primum and the AV cushions, known as the primary interatrial foramen or ostium primum (interatrial foramen primum), below the free margin of the septum.

Closing of ostium primum

This opening is closed by the union of the septum primum with the septum intermedium, and as the ostium primum closes, the communication between the atria is preserved with the formation of an opening in the upper part of the septum primum; this opening is known as the ostium secundum as it is chronologically the second opening that occurs in the septum primum.

A second entity, the septum secundum, develops to the right of the septum primum and the opening between the upper and lower limbs of the septum secundum is known as the foramen ovale of the heart. The part of the septum primum that remains to the left of the septum secundum acts as a one way flow valve due to the greater pressures in the right atrium compared to the left atrium. At birth the neonate begins breathing and the associated decrease in pulmonary vascular resistance leads to a reversal of the pressure differential between the atria. The left atrium now has a greater pressure than the right, effectively closing the one way flow valve formed by the two septa. The two septa fuse later in life, to complete the formation of the atrial septum.

Persistence of the ostium secundum is the most common atrial septal defect.^[1] Additionally, in a subset of the population, the foramen ovale is not overtly patent, however the two septa have not fused. In normal physiologic circumstances the septum primum acts as a one way valve preventing blood flow as described above, however if pathologic conditions cause right atrial pressure to exceed left atrial pressure, blood may flow through the foramen ovale from right to left.

Clinical significance

Failure of the septum primum to fuse with the atrio-ventricular cushion can lead to an ostium primum atrial septal defect.^[2] This is the second most common type of atrial septal defect^[1] and is commonly seen in Down's syndrome. Typically this defect will cause a shunt to occur from the left atrium to the right atrium. Children born with this defect may be asymptomatic, however, over time pulmonary hypertension and the resulting hypertrophy of the right side of the heart will lead to a reversal of this shunt. This reversal is called Eisenmenger syndrome.

References

This article incorporates text in the public domain from the 20th edition of Gray's Anatomy (1918)

^ ^a ^b Diagram of Ostium Secundum Atrial Septal Defect at Mayo Clinic
^ -402259967 at GPnotebook

External links

Embryology at Temple Heart98/heart97a/sld036
Overview and diagram at um.edu.mt
MedEd at Loyola GrossAnatomy/thorax0/Heart_Development/Atria.html

UpToDate Contents

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1. 成人における心房中隔欠損症の臨床症状および診断 clinical manifestations and diagnosis of atrial septal defects in adults
2. 小児における、心房中隔欠損（ASD）の分類および孤立性ASDの臨床的特徴および診断 classification of atrial septal defects asds and clinical features and diagnosis of isolated asds in children
3. 成人における心房中隔欠損症のマネージメント management of atrial septal defects in adults
4. 成人における心房中隔欠損症の特定および評価 identification and assessment of atrial septal defects in adults
5. 房室（AV）管欠損の臨床症状、病態生理、および診断 clinical manifestations pathophysiology and diagnosis of atrioventricular av canal defects

English Journal

Utility of three-dimensional transesophageal echocardiography for diagnosis of unroofed coronary sinus.

Kawamukai M1, Muranaka A2, Yuda S2,3, Sato Y4, Makiguchi N5, Tachibana K6, Hatakeyama K7, Takagi N6, Higami T6, Miura T2.
Journal of medical ultrasonics (2001).J Med Ultrason (2001).2016 Jan;43(1):91-4. doi: 10.1007/s10396-015-0648-y. Epub 2015 Jul 7.
We report a case of unroofed coronary sinus (URCS) in a 42-year-old female. At an outpatient clinic, she was found to have an atrioventricular septal defect and mitral regurgitation with pulmonary hypertension, and she was transferred to our institute for surgical treatment. Both atrioventricular va
PMID 26703172

[Fifteen years of minimally invasive paediatric cardiac surgery; development and trends].

Gil-Jaurena JM1, González-López MT2, Pérez-Caballero R2, Pita A2, Castillo R3, Miró L4.
Anales de pediatria (Barcelona, Spain : 2003).An Pediatr (Barc).2015 Jul 24. pii: S1695-4033(15)00242-8. doi: 10.1016/j.anpedi.2015.06.007. [Epub ahead of print]
INTRODUCTION: The minimally invasive approach is seldom reported in paediatric cardiac surgery. Teams gathering experience are scarce, with programs focused on simple cases. The experience is presented on a series of over 200 cases operated on in the past 15 years.MATERIAL AND METHODS: A sub-mammary
PMID 26216279

Clarifying the morphology of the ostium primum defect.

Anderson RH1, Mohun TJ, Brown NA.
Journal of anatomy.J Anat.2015 Mar;226(3):244-57. doi: 10.1111/joa.12272. Epub 2015 Feb 9.
The 'ostium primum' defect is still frequently considered to be the consequence of deficient atrial septation, although the key feature is a common atrioventricular junction. The bridging leaflets of the common atrioventricular valve, which are joined to each other, are depressed distal to the atrio
PMID 25676858

Japanese Journal

Heterotaxyの診断，病態，合併症

小川潔
日本小児循環器学会雑誌 30(2), 89-96, 2014
Heterotaxyは胸腹部臓器が体の左右軸に対して異常な位置関係を示すことと定義され，複合心奇形や幅広い心外病変を伴う疾患群である．右側相同では共通房室弁や円錐動脈幹異常，肺動脈狭窄／閉鎖，体・肺静脈還流異常が多く，左側相同では両側上大静脈，近位部下大静脈欠損を伴う奇静脈結合，心室中隔欠損，房室中隔欠損，左室流出路狭窄が多い．左側相同では先天性心疾患を伴わないこともあり，合併する心疾患も比較 …
NAID 130003398263

基礎心臓の発生「房室中隔の発生」

山岸敬幸
日本小児循環器学会雑誌 29(2), 68-74, 2013
房室中隔は右心房と左心室を隔て, 心房中隔と心室中隔に連なる組織である. 房室中隔は房室管の心内膜床から発生する. 原始心筒がloopingし, 心房・心室が形態的に明らかになる頃, 房室管部では心ゼリーが残存・増生する. 心内膜から上皮間葉転換により遊離して形質転換した間葉系細胞が, その心ゼリーの中に侵入し, 心内膜床が形成される. 心内膜床は, 主に上方(背側)および下方(腹側)から隆起して …
NAID 130003380017

肺動脈狭窄を合併した高齢者不完全型房室中隔欠損症の１手術例

窪田武浩,大久保祐樹,本橋雅寿,佐々木重幸,松居喜郎
日本心臓血管外科学会雑誌 40(1), 34-37, 2011
症例は72歳女性．19歳時に心房中隔欠損症と診断されるも放置していた．67歳頃心不全症状が強まり近医通院治療をしていた．71歳時に腹水の貯留が著明となり前医入院治療，精査の結果，不完全型房室中隔欠損症，両側房室弁逆流，肺動脈弁狭窄症，心房細動，左冠動脈前下行枝狭窄と診断され，当科紹介受診した．手術に先立ち，左前下行枝にベアメタルステントを留置した．72歳時に房室弁形成術，一次中隔欠損孔閉鎖術，肺動 …
NAID 130004548297

Related Pictures

★リンクテーブル★

リンク元	「一次孔」
関連記事	「ostium」

「一次孔」

Primary interatrial foramen
	Interior of dorsal half of heart from a human embryo of about thirty days. (Ostium primum visible below septum primum, but not labeled.)
Details
Latin	foramen primum
Identifiers
Gray's	p.512
Code	TE E5.11.1.5.2.1.1
	Anatomical terminology