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A survey of the indications for early closure of ostium secundum atrial septal defects and subsequent progress of children in whom this has been undertaken

Authors:

Ruwan Nandana Morawakkorala ,

Department of Paediatric Cardiology, Southampton University Hospital, United Kingdom,, LK
About Ruwan
Fellow in Paediatric Cardiology, Department of Paediatric Cardiology, Southampton University Hospital, United Kingdom
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James Gnanapragasam

United Kingdom, GB
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Consultant Paediatric Cardiologist, United Kingdom

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Abstract

Objectives: Closure of isolated secundum atrial septal defect (ASD) is generally recommended at the age of 4 to 5 years. However, there are children with isolated secundum ASDs in whom early closure is performed. The aim of this study is to describe the conditions that led to the decision for early closure and to determine whether these conditions were resolved by means of closure of the defect.

Methods: The records of 16 patients who underwent surgical closure of isolated ASD before 24 month of life from 2001 to 2010 at Southampton University Hospital were scrutinised to collect data.

Results: There were eight patients with recurrent respiratory tract infections and failure to thrive, three with only recurrent respiratory tract infection, two with evidence of high pulmonary pressures and one with heart failure. Two patients were asymptomatic but had large defects with significant right sided volume overloading. All patients survived surgery and most of them had an uneventful postoperative period. All patients showed clear improvement of their symptoms during the follow up period. Two patients continued to fail to thrive despite closure of ASD but both had other problems to account for the failure to thrive.

Conclusion: All symptomatic patients with ostium secundum ASD improved following closure of the ASD before two years of age. Co-existing chromosomal or non cardiac anomalies can be associated with a continued tendency to a poor weight gain after ASD closure.

(Key words: Ostium secundum atrial septal defects in infancy; surgical closure)

DOI: http://dx.doi.org/10.4038/sljch.v41i3.4600


How to Cite: Morawakkorala, R.N. and Gnanapragasam, J., 2012. A survey of the indications for early closure of ostium secundum atrial septal defects and subsequent progress of children in whom this has been undertaken. Sri Lanka Journal of Child Health, 41(3), pp.118–122. DOI: http://doi.org/10.4038/sljch.v41i3.4600
Published on 31 Aug 2012.
Peer Reviewed

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