Surgical closure of atrial septal defect in children under two years of age.

Abstract

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.

• Authors: Usha Parvathy, Komarakshi R Balakrishnan, Madathil S Ranjith, Richard Saldanha, Mahesh Vakamudi
• Journal: Asian cardiovascular & thoracic annals (Asian Cardiovasc Thorac Ann) Vol. 12 Issue 4 Pg. 296-9 (Dec 2004) ISSN: 0218-4923 [Print] England
• PMID: 15585696 (Publication Type: Journal Article)

Topics

• Age Factors
• Cardiomegaly (etiology)
• Failure to Thrive (etiology)
• Female
• Follow-Up Studies
• Heart Septal Defects, Atrial (complications, surgery)
• Humans
• Infant
• Male
• Recurrence
• Respiratory Tract Infections (etiology)
• Retrospective Studies
• Treatment Outcome