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Secundum atrial septal defect encountered in infancy
Insights
Infants with symptomatic secundum atrial septal defects face increased mortality risk. Early surgical closure of these atrial septal defects (ASDs) in infants unresponsive to medical management offers excellent outcomes.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Pediatric Cardiac Surgery
Background:
- Secundum atrial septal defects (ASDs) are common congenital heart anomalies.
- Infantile presentation of ASDs can be associated with significant morbidity and mortality.
- Optimal timing for intervention in symptomatic infants remains a critical consideration.
Purpose of the Study:
- To evaluate the outcomes of early surgical repair for secundum atrial septal defects in infants.
- To assess the risks associated with medical management versus surgical intervention in this population.
- To determine the long-term clinical results of surgical repair in infancy.
Main Methods:
- Retrospective review of pediatric patients diagnosed with isolated secundum ASD at the Mayo Clinic between 1953 and 1972.
- Analysis of patient demographics, clinical presentation, management strategies (medical vs. surgical), and outcomes.
- Focus on patients initially seen before the age of 2 years.
Main Results:
- Approximately 170 pediatric patients with secundum ASD were identified.
- Thirteen patients were initially assessed before age 2, with 11 exhibiting symptoms and one mortality.
- Four infants with symptomatic ASDs unresponsive to medical therapy underwent successful early surgical repair.
Conclusions:
- Infants with symptomatic isolated secundum atrial septal defects (ASDs) are at elevated risk of mortality.
- Early surgical closure should be considered for infants with ASDs who do not respond adequately to medical therapy.
- Surgical repair in infancy is associated with minimal risk and excellent short- and long-term clinical results.
Abstract:
From 1953 to 1972, approximately 170 patients less than 16 years old were seen at the Mayo Clinic for isolated secundum atrial septal defect. Thirteen of these patients were initially seen when they were less than 2 years old. Eleven of the patients had symptoms, and one of these died. Four patients failed to respond to medical management and underwent successful repair of their defects before they were 2 years old. Infants with isolated secundum atrial septal defect and significant symptoms are at an increased risk of death. Consideration should be given to early surgical closure of the defect in those infants who do not respond promptly and completely to medical therapy. Surgical repair in infancy can be accomplished with minimal risk and excellent early and long-term clinical results.