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Prevalence of pericardial effusions in children with large atrial or ventricular septal defect

Surendranath Reddy Veeram Reddy1, Ronald Lee Thomas, Robert David Ross

  • 1Carmen and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan, USA.

The American Journal of Cardiology
|January 6, 2009
PubMed

Insights

Pericardial effusions are rare in children with unrepaired atrial septal defects (ASD) or ventricular septal defects (VSD). While trace effusions are more common in ASD patients than VSD or normal children, large effusions are uncommon in all pediatric groups.

Area of Science:

  • Pediatric Cardiology
  • Cardiac Imaging
  • Congenital Heart Disease

Background:

  • Adults with surgical repair of atrial septal defects (ASD) and ventricular septal defects (VSD) often present with pericardial effusions (PE).
  • Pericardial effusions are perceived as uncommon in pediatric patients with unrepaired ASD or VSD.

Purpose of the Study:

  • To determine the prevalence of pericardial effusions in children with ASD compared to VSD and healthy controls.
  • To evaluate the association between septal defect size and pericardial effusion presence.

Main Methods:

  • Retrospective review of preoperative echocardiograms from 256 children.
  • Groups included: isolated secundum ASD (n=90), isolated VSD (n=75), and normal controls (n=91).
  • Assessment for presence/absence of pericardial effusions and septal defect size.

Main Results:

  • Global pericardial effusions were rare (0.4%, 1/256 patients).
  • Trace effusions were present in 32% of children overall.
  • Prevalence of trace effusions was higher in ASD (40%) and VSD (31%) groups compared to controls (24%), with ASD showing a significant increase (p<0.03).

Conclusions:

  • Global pericardial effusions are rare in pediatric patients with unrepaired ASD or VSD.
  • Trace pericardial effusions are more prevalent in children with ASD than VSD or controls.
  • Trace effusions in ASD may indicate a potential for larger effusions over time before defect closure.

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