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[Atrial septum defect: comparison of pre-and postsurgery echocardiographic data in adults and children]
Insights
Surgical closure of atrial septum defects improved right ventricular size and septal motion in children more effectively than in adults. Adults showed persistent abnormal septal motion, possibly due to long-standing shunt effects on ventricular compliance.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Cardiac Surgery
Background:
- Atrial septum defects (ASDs) can lead to right ventricular dilation and abnormal septal motion.
- Surgical closure is the standard treatment for ASDs.
- Differences in surgical outcomes between adult and pediatric populations are not fully understood.
Observation:
- Echocardiographic data were collected from 13 adults and 17 children before and after ASD surgical closure.
- Pre-surgery, children had larger right ventricular end-diastolic dimensions compared to adults.
- Septal motion was abnormal in a majority of both adults (92%) and children (65%) pre-surgery.
Findings:
- Post-surgery, right ventricular dimensions decreased similarly in both groups but often remained dilated.
- Septal motion normalized in 76% of children versus 25% of adults two weeks post-surgery (p<0.01).
- At four months, septal motion normalized in all children but only 50% of adults (p<0.005), with unchanged right ventricular dimensions.
Implications:
- Children experience more complete recovery of right ventricular function and septal motion post-ASD closure compared to adults.
- Persistent abnormal septal motion in adults may indicate chronic right ventricular compliance changes from long-standing shunts.
- Further research into long-term ventricular remodeling and compliance in adult ASD patients is warranted.
Abstract:
Echocardiographic data in 13 adults and 17 children before and after surgical closure of an atrial septum defect are compared. Before surgery the enddiastolic dimension of the right ventricle was bigger in children than in adults. Septal motion was paradoxal or abnormal in 92% of adults and 65% of children (NS). Two weeks after surgery the right ventricle had decreased similarly in adults and in children, but often remained dilated. Septal motion was normal in 25% of adults and 76% of children (p less than 0.01). Four months after surgery, the right ventricle dimension was unchanged; septal motion was normal in all children but only in 50% of adults (p less than 0.005). This remaining abnormal septal motion after surgery may be explicable by the long-standing presence before surgery of a major shunt inducing chronic disturbances of right ventricular compliance.