Secundum atrial septal defect encountered in infancy

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.