Keywords
cardiac surgery
Atrial Septal Defects
How to Cite
Abstract
Introduction and objectives: Atrial septal defects (ASDs) account for 6-10% of congenital heart defects. The most prevalent type, with the most variable clinical and therapeutic approach, is the ostium secundum(OS). The objective of this study is to describe the clinical and evolutionary characteristics, as well as the clinical and echocardiographic prognostic factors, of patients requiring closure of the defect.
Materials and methods: Retrospective observational study of patients diagnosed with ASD. Variables studied: ASD type, size, age at diagnosis and at closure, and type of closure.
Results: Predominance in males(55.4%), with OS being the most frequent(80.3%). 25% presented with heart failure during their follow-up, and 24.2% required nutritional support. At diagnosis, the mean age and size were 17.71 months and 6.5 mm. Spontaneous closure occurred in 15.2%, closure was achieved with a device in 24.2%, surgical closure was required in 30.3%. Ostium primum(OP) and sinus venosus(SV) ASDs required external closure. Age at closure was not a significant factor, but OS and SV were larger. OS ASDs were analyzed, revealing a 2.5-fold increased risk in males and a 7.33-fold increased risk of requiring closure in sizes >5 mm at diagnosis. No factors were found to indicate a preference for surgical or device-assisted closure.
Conclusions: The most frequent ASD was type OS, with closure being more frequently in males and in those with a size greater than 5 mm at diagnosis, without finding prognostic factors for the type of closure. All OP and venous sinus ASDs required surgical closure.
References
Sadler TW. Capítulo 13. Embriología médica. 15ª ed. Philadel- phia: Elsevier; 2020. p. 181-224.
Carreras Blesa C, Pérez Lara L. Anatomía y fisiología normal del sistema circulatorio. En: Perin F, Rodríguez M, Carreras C, editoras. Cardiología Pediátrica para residentes de Pediatría. Granada: Educatori; 2023. p. 13-21.
Oliver JM, Gutiérrez-Fernández P, Barba E, Sobrino A, Alday J, Macaya C, Sobrino J. Cierre quirúrgico de la comunicación interauricular antes o después de los 25 años de edad. Compa- ración con la evolución natural en pacientes no operados. Rev Esp Cardiol. 2002;55(9):953-61. https://doi.org/10.1016/S0300-8932(02)76734-1
Tanghöj G, Liuba P, Sjöberg G, Naumburg E. Predictors of the need for an atrial septal defect closure at very young age. Front Cardiovasc Med. 2020;6(185):1-8. https://doi.org/10.3389/fcvm.2019.00185
Costanzo LS. Capítulo 4. Fisiología. 6ª ed. Barcelona: Elsevier; 2019. p. 117-158.
Maragiannis D, Little SH. Interventional imaging: the role of echocardiography. Methodist Debakey Cardiovasc J. 2014;10(3):172-7. https://doi.org/10.14797/mdcj-10-3-172
Zabal-Cerdeira C, García-Montes JA, Sandoval-Jones JP, Cal- derón-Colmenero J, Patiño-Bahena E, Juanico-Enríquez A, Buendía-Hernández A. Cierre percutáneo de la comunicación interauricular con el dispositivo Amplatzer®: 15 años de expe- riencia. Arch Cardiol Mex. 2014;84(4):250-5. https://doi.org/10.1016/j.acmx.2013.10.013
Bialkowski J, Kusa J, Szkutnik M, Kalarus Z, Banaszak P, Ber- múdez-Cañete R, et al. Cierre percutáneo de la comunicación interauricular. Rev Esp Cardiol. 2003;56(4):383-8. https://doi.org/10.1016/S0300-8932(03)76882-1
Gil-Jaurena JM, Martínez Miguel M, Agudo-López M, Gonzá- lez-López L, Martínez-Romero R, Valverde-Molina M, Gómez- González M. Estudio comparativo de la vía de abordaje en el cierre de la comunicación interauricular. Rev Esp Cardiol. 2002;55(11):1213-6. https://doi.org/10.1016/S0300-8932(02)76787-0
Oliver JM, Gallego P, González AE, Benito F, Sanz E, Aroca A, et al. Cierre quirúrgico de la comunicación interauricular. Rev Esp Cardiol 2002;55(9):953-61. https://doi.org/10.1016/S0300-8932(02)76734-1
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