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Alan L. Saroff, MD
The Mountainside Hospital Montclair, NJ

JAMA. 1988;259(4):519.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—The Sept 18 issue of JAMA carried a letter entitled "Persistence of Enlarged Pulmonary Arteries—22 Years After Atrial Septal Defect Closure."¹ The letter describes markedly dilated pulmonary vessels in a patient who presumably had his atrial septal defect successfully closed 22 years prior to the observation.

Unfortunately, Gould and associates do not conclusively demonstrate that the atrial septal defect was adequately closed.

There was no mention of any attempt to demonstrate a step-up in oxygen saturation at the right atrial level and no hydrogen arrival time procedure was carried out.

No mention is made of the second heart sound. This should show fixed splitting if the atrial septal defect were still present, but should be normally split (moving with respiration) if the defect had been successfully closed. . . . [Full Text PDF of this Article]

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