Related Experiment Videos
Right ventricular size and ventricular septal motion after repair of atrial septal defect in children
Insights
Even after successful surgical closure of atrial septal defects, many children retain enlarged right ventricles and abnormal septal motion. Early surgical intervention is recommended to prevent persistent echocardiographic abnormalities in pediatric patients.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Congenital Heart Disease
Background:
- Enlarged right ventricle and abnormal septal motion are common echocardiographic findings in atrial septal defects (ASD).
- These features often persist post-surgical closure, even with clinically successful outcomes.
Purpose of the Study:
- To evaluate the persistence of echocardiographic abnormalities in children after surgical closure of ASD.
- To determine the optimal timing for surgical intervention in relation to right ventricular dimensions.
Main Methods:
- Retrospective analysis of echocardiographic data from children who underwent ASD closure between 1976 and 1979.
- Assessment of right ventricular dimension and septal motion 15 to 21 months post-operation.
Main Results:
- Approximately two-thirds of children exhibited enlarged right ventricular dimensions 18 months post-surgery.
- A similar proportion showed abnormal septal motion despite satisfactory clinical results.
- These echocardiographic findings persisted despite successful surgical closure.
Conclusions:
- Persistent right ventricular enlargement and abnormal septal motion are common sequelae after ASD closure.
- Early surgical intervention, when right ventricular end-diastolic dimension is small, may be the optimal strategy.
Abstract:
An enlarged right ventricle and abnormal ventricular septal motion are characteristic echocardiographic features of atrial septal defect and often persist after the defect has been completely closed, even when the operation clinically is judged to be successful. These features were examined retrospectively 15 to 21 months after operation in a group of children whose atrial septal defect had been closed between January 1976 and July 1979. Despite satisfactory postoperative results in all, about two thirds had an enlarged right ventricular dimension and about the same number had abnormal septal motion when examined echocardiographically an average of 18 months after operation. The best operative strategy seems to be to operate while the right ventricular end-diastolic dimension is still relatively small in echocardiographic terms.