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Clinical course of atrial septal defect in children

Published online by Cambridge University Press:  19 August 2008

Ling Han ,
José A. Ettedgui  and
James R. Zuberbuhier
Ling Han
Affiliation:
From the Division of Pediatric Cardiology, Children's Hospital of Pittsburgh, Universiiy of Pittsburgh School of Medicine, Pittsburgh
José A. Ettedgui
Affiliation:
From the Division of Pediatric Cardiology, Children's Hospital of Pittsburgh, Universiiy of Pittsburgh School of Medicine, Pittsburgh
James R. Zuberbuhier*
Affiliation:
From the Division of Pediatric Cardiology, Children's Hospital of Pittsburgh, Universiiy of Pittsburgh School of Medicine, Pittsburgh
*
Division of Pediatric Cardiology, Children's Hospital of PittsburghOne Children's Place, 3705 Fifth Avenue at DeSow Street, Pittsburgh, PA 15213, USA.
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Abstract

The incidence of spontaneous closure of uncomplicated defects of the oval fossa was determined in cohort of 498 children. Surgical repair was accomplished in 428 at a median age of 4.5 years. Of the 70 who did not undergo surgery, 20 showed spontaneous closure or a decrease in size of the defect. The defect was unchanged in the other 50. The age at diagnosis, pulmonary-to-systemic flow ratio and size of the defect were not statistically significantly different in the changed and unchanged groups, and there was no difference in prevalence of symptoms, the triad of systolic and diastolic murmurs and abnormal splitting of the second sound, or of right ventricular enlargement by echocardiography. The rate of spontaneous diminution in size or actual closure of a defect in this series was 4%, and no clinical predictor of change in the size of a defect was identified. Thus, delay in repair of a large flow atrial septal defect in the hope of spontaneous closure is not justified, whether or not symptoms are present.

Keywords

Atrial septal defectspontaneous closureaneurysm of atrial septum
Type
Original Articles
Information
Cardiology in the Young , Volume 2 , Issue 2 , April 1992 , pp. 141 - 146
Copyright
Copyright © Cambridge University Press 1992

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