An echocardiographic study on asymptomatic multiple interatrial septal defects in newborns

Area of Science:

• Neonatal Cardiology
• Pediatric Echocardiography
• Congenital Heart Defects

Background:

• The interatrial septum plays a crucial role in fetal circulation and neonatal cardiac adaptation.
• Multiple interatrial openings, including patent foramen ovale and fenestrations, can occur in neonates.
• Understanding the prevalence and natural history of these openings is important for clinical management.

Purpose of the Study:

• To investigate the prevalence of multiple interatrial septal openings in Chinese neonates.
• To characterize the locations and types of these openings.
• To evaluate the spontaneous closure rate of these openings over the first six months of life.

Main Methods:

• Prospective study involving 130 Chinese neonates.
• Color flow mapping echocardiography performed within the first week of life.
• Follow-up echocardiography at one, three, and six months of age for a subset of neonates.

Main Results:

• Nine out of 130 neonates (7%) presented with multiple interatrial openings.
• A total of 20 openings were identified across the nine neonates, with most having two openings.
• Location A openings (valve-like) and Location B openings (fenestrations) were observed.
• Spontaneous closure was observed in 4/6 Location A openings and 7/8 Location B openings by six months.

Conclusions:

• Multiple interatrial openings are present in a significant percentage of Chinese neonates.
• These cardiac openings demonstrate a high rate of spontaneous closure within the first six months.
• The location of the openings does not appear to significantly affect their spontaneous closure rate.