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[Symptomatic atrial septal defect in infancy (author's transl)]
Insights
This study highlights that isolated atrial septal defects causing congestive heart failure often require surgical intervention for improved outcomes. Early surgery is crucial for survival and normal development in affected children.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Isolated atrial septal defects (ASD), specifically ostium secundum type, can lead to significant clinical manifestations.
- Congestive heart failure is a notable symptom in pediatric patients with these defects.
Purpose of the Study:
- To present cases of isolated ostium secundum atrial septal defects.
- To evaluate the clinical presentation, diagnostic findings, and treatment outcomes.
Main Methods:
- Case series of seven patients with isolated ostium secundum ASD.
- Clinical evaluation, echocardiography, and cardiac catheterization with contrast angiography were utilized.
- Surgical intervention was compared to medical management.
Main Results:
- All patients presented with congestive heart failure, cardiomegaly, and right ventricular hypertrophy.
- Echocardiography revealed paradoxical interventricular septal movement and diastolic overflow.
- Five patients underwent surgery, showing significant clinical improvement and normal growth post-operatively.
Conclusions:
- Isolated ostium secundum ASD presenting with heart failure necessitates surgical correction.
- Early surgical intervention is vital for survival and achieving normal developmental trajectories in affected children.
Abstract:
Seven cases of isolated atrial septal defect, "ostium secundum" type, are presented. All had clinical symptoms of congestive heart failure and represented five per cent of the cases studied in our department with atrial septal defect. In three patients associated extracardiac anomalies were found. All had cardiomegaly, increased pulmonary vascularity, right ventricular hypertrophy and splitted second sound. Echocardiographic findings were: paradoxal movement of the interventricular septum and ventricular dyastolic overflow. Medium left to right shunt was 3.08. In four cases a massive filling of the right atrium was obtained, through, the selective injection of contrast material, in the pulmonary artery. None of the patients, responded to medical treatment alone and five of then went to surgery with significant improvement, in their clinical manifestations, and normal growth and weight curves in their follow-up. Importance in survival of early surgery is emphasized.