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Pulmonary function in children with atrial septal defect before and after heart surgery
Insights
Pulmonary function abnormalities persist in half of children nearly two years after atrial septal defect (ASD) surgery. Lung function impairment is linked to the heart condition itself, not the surgical intervention.
Area of Science:
- Pediatric Cardiology
- Pulmonary Medicine
- Thoracic Surgery
Background:
- Atrial septal defect (ASD) can impact respiratory health.
- Surgical correction of ASD is common in children.
- The long-term effects of ASD surgery on lung function require further investigation.
Purpose of the Study:
- To evaluate the impact of heart disease and subsequent surgery on pediatric lung function.
- To assess changes in lung volumes, elasticity, and airway patency after ASD repair.
Main Methods:
- Pulmonary function tests were conducted on children before and after surgical correction of ASD.
- Measurements included lung volumes, lung elasticity, and airway patency indices.
- 26 children were tested pre-surgery and 24 post-surgery (1.8 years follow-up).
Main Results:
- Pre-surgery, 18 of 26 children showed pulmonary function abnormalities, including stiff lungs and hyperinflation.
- Post-surgery, 12 of 24 children still had abnormalities, with persistent stiff lungs and airway obstruction.
- No significant correlation was found between perioperative events and pulmonary function outcomes.
Conclusions:
- Pulmonary function abnormalities remain in approximately half of children almost two years after ASD surgery.
- The observed lung function impairment is primarily associated with the underlying atrial septal defect, not the surgical procedure.
- Further research may explore specific interventions to mitigate persistent pulmonary issues post-ASD repair.
Objective:
To test the effect of heart disease and heart surgery on lung function.
Design:
A pulmonary function study of children undergoing surgery for atrial septal defect (ASD).
Settings:
University hospital.
Patients:
26 children tested before surgery (at mean (SD) age 11.8 (3.8) years) and 24 patients tested 1.8 (0.2) years after surgical correction.
Methods:
Lung volumes, lung elasticity, and airway patency indices were measured using standard techniques.
Results:
Before surgery: pulmonary function test abnormalities were found in 18 of the 26 patients. Stiff lung was found in 12, lung hyperinflation in five, and indices of decreased airway patency in four. Total lung capacity decreased in only two patients. After surgery: pulmonary function test abnormalities were found in 12 of the 24 patients (informed consent not given for two patients). Stiff lung was detected in nine and indices of peripheral airway obstruction in four. Mean values of specific airway conductance and peak expiratory flow were all normal. Lung hyperinflation was found only in one of 24 patients. No correlation between perioperative events and pulmonary function test data was found.
Conclusions:
Pulmonary function test abnormalities persist in half the patients almost two years after surgery for ASD. A decrease in the total frequency of pulmonary function test abnormalities (in 19% of the patients), with a decrease in stiff lung in 8% and lung hyperinflation in 15%, was not significant. Impairment of lung function related to ASD is associated with the disease itself rather than the surgical procedure.