Complex of secundum atrial septal defect and congestive heart failure in infants

Phillips, Sidney; Okies, J. Edward; Henken, Dale P.; Sunderland, Cecille O.; Starr, Albert

doi:10.1016/s0022-5223(19)40300-0

Cited by 36 publications

(10 citation statements)

References 11 publications

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“…Earlier surgery might have been beneficial for those patients with ASD and worsening respiratory status. For clinically complicated patients, the defect is best closed sooner to prevent the development of further pulmonary vascular damage and perhaps may improve their clinical condition [6,17]. Y axis represents z score of body weight at standard growth chart (CDC 0 to 36 months, male or female).…”

Section: Asd Closure Resulted In Significant Clinical Improvement In Symptomatic Patients Younger Than 2 Years Of Agementioning

confidence: 99%

“…Early closure of ASD during infancy has been historically more controversial. Occasionally, an isolated ASD may be associated with congestive heart failure in infancy, and the early closure appears to be beneficial [4][5][6]. In addition, patients with underlying pulmonary abnormalities including lung disease related to prematurity, bronchopulmonary dysplasia (BPD), or chronic aspiration may be adversely affected by increased pulmonary blood flow, and some have advocated early ASD closure to improve outcome in these patients [7].…”

Section: Introductionmentioning

confidence: 99%

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Early Surgical Closure of Atrial Septal Defect Improves Clinical Status of Symptomatic Young Children with Underlying Pulmonary Abnormalities

et al. 2020

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Elective closure of atrial septal defect (ASD) is usually recommended during preschool ages. However, ASD may contribute to deteriorating health in the presence of significant comorbidity and, thus, may need earlier closure. There is a lack of clarity regarding the indications for and outcomes after ASD closure in infancy and early childhood. We investigated the benefits and safety of surgical ASD closure in symptomatic patients under 2 years of age. Retrospective chart review was conducted in patients who underwent surgical ASD closure within the first 2 years of life. Of 31 symptomatic ASD patients, 22 had persistent respiratory symptoms, 24 failure to thrive, and 9 pulmonary hypertension. Overall, 26 patients (84.0%) showed clinical improvement after ASD closure, including improved respiratory status (17/22; 77.3%), resumption of normal growth (15/24; 62.5%), and resolution of pulmonary hypertension (7/7; 100%, 2 patients unable to assess postoperatively). Two medically complicated patients died a few months after surgery unrelated to surgical complications. Four out of 8 ventilator-dependent patients were weaned from mechanical ventilation within 1 month after ASD closure. Closure of ASD did not improve those patients with highly advanced lung disease and/or medically complex conditions including underlying genetic abnormalities. Surgical complications were uncommon. Postoperative hospital stay was 4 to 298 days (median 8 days). The majority of our patients demonstrated significant clinical improvement after ASD closure. Early ASD closure is safe and beneficial for symptomatic infants and young children with associated underlying pulmonary abnormalities, especially bronchopulmonary dysplasia.

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Section: Asd Closure Resulted In Significant Clinical Improvement In Symptomatic Patients Younger Than 2 Years Of Agementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Early Surgical Closure of Atrial Septal Defect Improves Clinical Status of Symptomatic Young Children with Underlying Pulmonary Abnormalities

et al. 2020

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“…However, there are some recent reports where improved techniques have shown favorable results of early operative intervention for symptomatic secundum ASD. 4,13,14,18,19…”

Section: Discussionmentioning

confidence: 99%

Surgical Closure of Atrial Septal Defect in Children under Two Years of Age

Parvathy¹,

Balakrishnan²,

Ranjith³

et al. 2004

Asian Cardiovasc Thorac Ann

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Infants with atrial septal defects are seldom symptomatic and usually require elective surgery between 2 and 4 years of age. However a small minority is symptomatic and management at this age has been controversial. This study evaluated surgical closure of atrial septal defect below 2 years of age. Eighteen infants with a mean age of 13.4 +/- 5.7 months were operated on for secundum atrial septal defect from 1994 to 2001. Fourteen patients were symptomatic with failure to thrive in 7 and recurrent respiratory infections in 7, one had increasing cardiomegaly, and 3 were operated on early for social reasons. The defect was isolated in 11 patients (61%) and the other 7 (39%) had minor associated lesions requiring additional procedures such as ductal ligation, direct closure of a tiny ventricular septal defect, and inspection of the mitral valve. There were no early or late deaths. The postoperative course was complicated by pulmonary problems in 4 cases. Of the 16 patients available for follow-up, 14 were asymptomatic and 2 were symptomatically improved. Most showed a dramatic improvement in growth and development. These gratifying results indicate that consideration should be given to early surgical closure of atrial septal defect in symptomatic infants.

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“…Indeed, rather commonly the defect is discovered at medical screening at a later age. Occasionally, nonetheless, the septal defect is diagnosed in the first two years in those patients who may suffer from congestive heart failure, 1 present with frequent chest infecions, 2 or experience poor growth and weight gain. 3 These patients may also have elevated pulmonary arterial pressures which, in the past, have contributed to an increased Correspondence to: Prof. Dr Michael Vogel MD, PhD, GUCH Department, Middlesex Hospital, Mortimer Street, London WIN 8AA, UK.…”

Section: Hildren With Atrial Septal Defects Rarelymentioning

confidence: 99%

Treatment of atrial septal defects in symptomatic children aged less than 2 years of age using the Amplatzer septal occluder

et al. 2000

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Complex of secundum atrial septal defect and congestive heart failure in infants

Cited by 36 publications

References 11 publications

Early Surgical Closure of Atrial Septal Defect Improves Clinical Status of Symptomatic Young Children with Underlying Pulmonary Abnormalities

Early Surgical Closure of Atrial Septal Defect Improves Clinical Status of Symptomatic Young Children with Underlying Pulmonary Abnormalities

Surgical Closure of Atrial Septal Defect in Children under Two Years of Age

Treatment of atrial septal defects in symptomatic children aged less than 2 years of age using the Amplatzer septal occluder

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