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Published on: February 8, 2022
Outcome following surgical closure of secundum atrial septal defect
D A Jones1, D J Radford, P G Pohlner
1Queensland Centre for Congenital Heart Disease, The Prince Charles Hospital, Brisbane, Queensland, Australia. jonesda@mailbox.uq.edu.au
Insights
Surgical closure of secundum atrial septal defects (ASD) in children is generally safe, but 24.1% experience complications. Children over 5 may face higher risks of pericardial effusion and post-pericardiotomy syndrome (PPS).
Area of Science:
- Pediatric Cardiology
- Thoracic Surgery
- Congenital Heart Disease
Background:
- Secundum atrial septal defects (ASD) are common congenital heart abnormalities.
- Surgical intervention remains a primary treatment modality for significant ASDs.
- Understanding postoperative outcomes in pediatric populations is crucial for clinical management.
Purpose of the Study:
- To evaluate the outcomes of surgical closure for secundum ASD in Australian children.
- To identify complication rates and risk factors associated with the procedure.
Main Methods:
- Retrospective chart review of 87 pediatric patients undergoing ASD closure.
- Data collected for surgeries performed between August 1995 and March 1999.
- Analysis of patient demographics, surgical procedures, and postoperative complications.
Main Results:
- No mortality was observed in the study cohort.
- 24.1% of patients experienced complications requiring further intervention.
- 11.5% developed pericardial effusion needing drainage, and 5.7% had post-pericardiotomy syndrome (PPS).
- Children over 5 years old showed a trend towards increased risk of effusion or PPS (OR 2.31).
Conclusions:
- Surgical ASD closure typically results in uncomplicated recovery for most pediatric patients.
- A notable minority experience complications, leading to extended hospital stays.
- Children aged over 5 years may be at higher risk for developing pericardial effusion or PPS, warranting further investigation.
Objective:
To assess the current outcome of surgical closure of secundum atrial septal defects (ASD) in an Australian paediatric population.
Methodology:
A retrospective chart review of 87 children, aged 2 months to 15 years, was performed for surgery between August 1995 and March 1999.
Results:
There were no deaths in the patients studied. Approximately one in four patients (24.1%) experienced complications requiring further management. Complication rates were similar to those published previously. However, one in nine patients (11.5%) required surgical drainage of a pericardial effusion. A total of five of 87 (5.7%) patients developed post-pericardiotomy syndrome (PPS), of whom four required pericardiocentesis. The risk for developing a pericardial effusion requiring drainage or PPS was more than twice in children older than 5 years of age at the time of surgery compared to those aged under 5 years, although there was an insufficient number of subjects in the study to prove this statistically (Odds ratio 2.31).
Conclusions:
Most patients have an uncomplicated postoperative course following surgical closure of secundum ASD. However, a significant minority (24.1%) do develop complications requiring further management and have a correspondingly longer period of hospitalization. Patients older than 5 years of age were identified as being potentially at greater risk for the development of PPS or a pericardial effusion requiring drainage. Further research needs to be performed to clarify this.
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