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[Circulatory and respiratory systems in children after surgical correction of atrial septal defect type II (ASD II)]
1Klinika Kardiologii Dzieciecej Slaskiej Akademii Medycznej w Katowicach.
Insights
Surgical correction of atrial septal defect (ASD II) in children shows efficient circulatory systems but nearly 40% experience cardiac arrhythmias. Some pulmonary abnormalities, including reduced lung diffusion capacity, may persist or worsen post-surgery.
Area of Science:
- Cardiology and Thoracic Surgery
- Pediatric Cardiovascular Health
- Pulmonary Function Testing
Context:
- Atrial Septal Defect (ASD II) is a congenital heart condition requiring surgical intervention.
- Long-term outcomes of ASD II surgical correction in pediatric populations are crucial for clinical practice.
- Evaluating post-operative circulatory and respiratory function is essential for assessing surgical success and patient recovery.
Purpose:
- To assess the circulatory and respiratory system conditions 1-5 years after surgical correction of ASD II in children.
- To compare the health status of post-operative ASD II patients with a control group of healthy children.
- To identify potential long-term complications or persistent abnormalities following ASD II surgery.
Summary:
- Post-surgical evaluation of 112 children 1-5 years after ASD II repair revealed efficient circulatory systems with mostly normal echocardiograms.
- However, nearly 40% of these children exhibited cardiac arrhythmias on 24-hour ECG monitoring, with significant arrhythmias in 17.8%, more frequent than in controls.
- Pulmonary function tests indicated a statistically significant deterioration in lung diffusion capacity (DL,CO[SB]) and Krogh transfer coefficient (D/VA) after surgery.
Impact:
- The study highlights that while ASD II surgical correction is effective for the circulatory system, cardiac arrhythmias remain a concern.
- Persistent or increased pulmonary abnormalities, particularly reduced lung diffusion capacity, suggest potential long-term respiratory implications.
- Findings underscore the need for continued monitoring of both cardiac and pulmonary functions in children following ASD II surgical correction.
Abstract:
The main objective of the study was to evaluate the conditions of circulatory and respiratory system 1-5 years after surgical correction of atrial septal defect (ASD II) in 112 children who had been operated at Silesian Medical Centre in Katowice in 1989-1993. Obtained results were compared with these ones found in the group of 60 healthy children. Mean age of study group was 7.78 +/- 4.46 years at the time of examination and 5.34 +/- 3.98 at the time of the operation. Twenty older children in the mean age 11 +/- 4.5 years (necessity for cooperation) were selected from the study group to perform the respiratory system tests. These tests were performed 7 days prior to operation and repeated 8 to 12 months afterwards. The following indices were determined: FVC--forced volume capacity, FRC--functional residual capacity, RV--residual volume, TLC--total lung capacity, FEV1--forced first second expiratory volume, PEF--peak expiratory flow, MEF 75-50-25% FVC--maximum expiratory flow at 75-50-25% of forced volume capacity, ITGV--intrathoracic gas volume, Raw-respiratory tract resistance, CL, st--static compliance of lung, DL, CO[SB]--lung diffusion capacity for carbon monoxide and D/VA--Krogh transfer coefficient. Circulatory system tests included: medical interview, physical examination, routine and 24-hour ambulatory ECG, echocardiography. There was found that children after ASD II closure have efficient circulatory system and most of them have normal ECHO results. Almost 40% of the children within 1 to 5 years following ASD operations have cardiac arrhythmias found in 24-hour ECG, but significant arrhythmias are seen only in 17.8% of the subjects. Most of the rhythm disturbances were mild. Significant arrhythmias and sinus node dysfunction were observed more frequently among the children who underwent surgical correction than in the healthy control group. Statistically significant deterioration of lung diffusion capacity for carbon monoxide (DL,CO[SB]) and Krogh coefficient (D/VA) has been found after the surgery. Thus, it is concluded that some pulmonary abnormalities may persist or even increase after successful ASD operation.