Long-term follow-up (9 to 20 years) after surgical closure of atrial septal defect at a young age

Meijboom, Folkert J.; Hess, John; Szatmári, András; Utens, Elisabeth M. W. J.; McGhie, Jacky; Deckers, Jaap W.; Roelandt, Jos R.T.C.; Bos, Egbert

doi:10.1016/0002-9149(93)90192-f

Cited by 137 publications

(85 citation statements)

References 24 publications

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“…In contrast to other studies showing a high incidence of persistent dilatation of the right ventricle in 20% to 80% of subjects, all of our patients had right and left ventricles with normal diameters [14,15,22,29]. It is important to note that these echocardiographic findings were confirmed by measurement of ventricular volumes using MRI, which is recognized as the gold standard for the assessment of cardiac ventricular volumes.…”

Section: Discussioncontrasting

confidence: 80%

“…This finding contradicts the results of a number of earlier studies in which arrhythmias were reported in £ 71% of subjects [2,3,14,16,20,23,24]. Many of these studies were conducted in the early days of open heart surgery with cardiopulmonary bypass.…”

Section: Discussioncontrasting

confidence: 69%

“…To compare the results we selected the following criteria in accordance with Meijboom et al [14]: (1) First-degree atrioventricular block was defined as an atrioventricular conduction time of >0.2 seconds, (2) right bundle branch block was defined as an RSR¢ pattern of the QRS complex with a duration of > 0.12 seconds, (3) right ventricular hypertrophy as a heart axis between 90°and 180°and R or R¢>0.5 mV in lead V 1 or R > S in lead V 1 in the absence of a right bundle branch block.…”

Section: Standard Electrocadiogrammentioning

confidence: 99%

“…Moreover, studies of long-term morbidity have shown better results for surgical closure in childhood as compared with closure in adults [8,[13][14][15][16][17]22]. Therefore, it is generally accepted that an ASD with a hemodynamically relevant left-to-right shunt needs to be closed during childhood.…”

mentioning

confidence: 99%

“…Findings related to long-term morbidity were mainly based on questionnaires and interviews [13,16,17]. Only a few studies have evaluated consecutive patient series after operation in childhood and assessed the clinical sequelae during long-term follow-up, and only Meijboom et al and RoosHesselink et al included bicycle ergometry and 24-hour electrocardiograms (ECG) in their studies [14,22]. Transcatheter closure with an occluding device is an alternative method that nowadays is also used frequently in children.…”

mentioning

confidence: 99%

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Long-term Outcome after Surgical Closure of Atrial Septal Defect in Childhood with Extensive Assessment Including MRI Measurement of the Ventricles

et al. 2005

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Abstract. Surgical closure of the secundum type of atrial septal defect (ASD) in childhood leads to excellent survival. However, relevant morbidity has been reported. Transcatheter closure of these defects has now become an alternative approach. To compare the results of the two different interventions, reliable data are needed on the long-term morbidity after defect closure with both methods. Patients were evaluated after a minimum of 10 years after surgical closure of an ASD in childhood. Assessment included analysis of perioperative data, interview, clinical examination, electrocardiogram, (ECG), 24-hour ECG, ergometry, chest radiograph, echocardiography, and MRI. A total of 66 patients underwent operation between 1971 and 1986 at our institution. Forty-eight of them (73%) were interviewed and 38 (58%) participated fully in the study program. Eighteen (27%) either refused to participate or were lost to follow-up. There were no substantial residual disorders, such as arrhythmias, right-sided heart dilatation, pulmonary hypertension, or reduced work capacity. Surgical closure of an ASD in childhood has an excellent long-term outcome. Surgical closure is thus the standard against which transcatheter closure needs to be measured.

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Section: Discussioncontrasting

confidence: 80%