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Spontaneous closure of interatrial septal openings in infants: an echocardiographic study
F Senocak1, S Karademir, F Cabuk
1Dr. Sami Ulus Children's Hospital, Ankara, Turkey.
Insights
Most neonatal interatrial septal openings close spontaneously within 18 months. Larger initial openings correlate with longer closure times, but size significantly impacts closure rates in neonates.
Area of Science:
- Neonatal cardiology
- Pediatric echocardiography
- Congenital heart defects
Background:
- Interatrial septal openings are common in neonates.
- Echocardiography is crucial for diagnosing these defects.
- Understanding spontaneous closure is vital for clinical management.
Purpose of the Study:
- To evaluate the prevalence and spontaneous closure of interatrial septal openings in neonates.
- To determine the impact of initial defect size on closure rates and time.
- To investigate the occurrence of septal aneurysms in relation to these openings.
Main Methods:
- Echocardiographic assessment of 415 neonates.
- Follow-up for up to 18 months.
- Statistical analysis of closure rates and influencing factors.
Main Results:
- 68.67% of neonates had interatrial septal openings in the first week.
- 50.18% of these defects were larger than 3 mm.
- Only 3 openings persisted at 18 months; larger initial size correlated with longer closure time.
- Spontaneous closure rates did not differ between sexes.
- Septal aneurysms formed in 4.64% of infants with closing openings and were detected in 12.3% of newborns without openings.
Conclusions:
- Neonatal interatrial septal openings demonstrate high spontaneous closure rates.
- Initial defect size is a significant predictor of spontaneous closure.
- Septal aneurysm formation is an infrequent outcome of interatrial septal opening closure.
Abstract:
Four-hundred-and-fifteen neonates were evaluated by echocardiographic means in order to detect interatrial septal openings and were followed for a maximum time of 18 months. In 68.67% of them, interatrial septal openings were present at the first week of life. The defects were larger than 3 mm in 50.18% of these infants. At the end of the 18th month, openings persisted in 3 cases. The statistical analyses showed significant difference about the percent of closing between the groups with initial opening sizes lesser and bigger than 3 mm. Also, there was a positive correlation between the initial size and the spontaneous closure time. Spontaneous closure incidences were not different in boys and girls. In a small group of infants (4.64%), interatrial openings close forming septal aneurysms. In 12.3% of the newborns without an opening, septal aneurysms were detected during the initial evaluation.