Outcome of children with atrial septal defect considered too small for surgical closure

Brassard, Myriam; Fouron, Jean‐Claude; Doesburg, Nicolaas H. van; Mercier, Lise‐Andrée; Guise, Pierre de

doi:10.1016/s0002-9149(99)00146-0

Cited by 49 publications

(28 citation statements)

References 7 publications

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“…For bigger defects with diameters of 6–7 mm after 1 year of age, yearly follow-up is recommended until 4 or 5 years of age 7. The survey described previously reveals that most paediatric cardiologists see patients with secundum ASD in follow-up on a yearly basis for small defects and more often for larger ones (40–45% see the patients at 6-month intervals) 18.…”

Section: Resultsmentioning

confidence: 99%

Controversies in the definition and management of insignificant left-to-right shunts

Cantinotti

Assanta

Murzi

et al. 2013

Heart

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Haemodynamically insignificant left-to-right shunts are frequently discovered when screening for congenital heart disease, resulting in significant economic and psychosocial impact. A literature search was performed within the National Library of Medicine using the keywords small/insignificant/silent atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA) and patent foramen ovale (PFO). The search was refined by adding the keywords definition, classification and follow-up. Our analysis revealed significant heterogeneity in the evaluation and management of innocent left-to-right shunts. The definitions for small defects vary greatly, making it difficult to distinguish between physiologic and pathologic lesions (eg, a PFO vs a true ASD). Most small defects will partially or completely resolve spontaneously early in life. If spontaneous resolution does not occur, the risk for long-term complications (such as embolic events and endocarditis) is low but poses several practical and ethical issues: immediate discharge versus long-term follow-up, duration and frequency of follow-up, and content and method of discussions with the parents. Additionally, there is controversy pertaining to treatment for PDAs and VSDs, particularly among interventional cardiologists, even though risk/benefit analyses are lacking. Standards and guidelines using consensus opinion for the management of insignificant left-to-right shunts are needed to address the heterogeneity in diagnosis and management as well as use of resources, ethical and psychosocial issues.

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Section: Resultsmentioning

confidence: 99%

Controversies in the definition and management of insignificant left-to-right shunts

Cantinotti

Assanta

Murzi

et al. 2013

Heart

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“…Numerous previous studies have shown a fairly high rate of spontaneous closure of ASD Ͻ8 mm in the first few years of life (10 -13), and rarely as late as adolescence (14). Due to the known high rates of spontaneous closure in the first year of life, it has been written, "One should be careful about proceeding too rapidly to close an ASD in an asymptomatic young patient" (15).…”

Section: Discussionmentioning

confidence: 99%

Device Closure of Secundum Atrial Septal Defects in Children <15 kg

Bartakian

Fagan

Schaffer

et al. 2012

JACC: Cardiovascular Interventions

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“…2,3 Spontaneous closure of an isolated ASD has been reported in 17-84% of infants and documented at ages 2-8 years. [4][5][6] However, if the defect persists until school age, it will not close. There is no obvious advantage in delaying repair beyond the teenage years and, in fact, such delay may increase the risk of diseases, such as supraventricular tachycardia, and ventricular dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Clinical Features of Asymptomatic Atrial Septal Defect in School Children Diagnosed by Heart Disease Screening.

Matsubara

Akagi

Egami

et al. 2003

Circ J

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Outcome of children with atrial septal defect considered too small for surgical closure

Cited by 49 publications

References 7 publications

Controversies in the definition and management of insignificant left-to-right shunts

Controversies in the definition and management of insignificant left-to-right shunts

Device Closure of Secundum Atrial Septal Defects in Children <15 kg

Incidence and Clinical Features of Asymptomatic Atrial Septal Defect in School Children Diagnosed by Heart Disease Screening.

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