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Outcome for patients with isolated atrial septal defects in the oval fossa diagnosed in infancy

Published online by Cambridge University Press:  08 January 2008

Tevfik Demir ,
Funda Öztunç ,
Ayşe Güler Eroğlu ,
Levent Saltık ,
Gülay Ahunbay ,
Şeyhan Kutluğ ,
Alper Güzeltaş  and
Gürkan Altun
Tevfik Demir*
Affiliation:
Department of Pediatrics, Medical Faculty, Kocatepe University, Afyonkarahisar, Turkey
Funda Öztunç
Affiliation:
Department of Pediatric Cardiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
Ayşe Güler Eroğlu
Affiliation:
Department of Pediatric Cardiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
Levent Saltık
Affiliation:
Department of Pediatric Cardiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
Gülay Ahunbay
Affiliation:
Department of Pediatric Cardiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
Şeyhan Kutluğ
Affiliation:
Department of Pediatric Cardiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
Alper Güzeltaş
Affiliation:
Department of Pediatric Cardiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
Gürkan Altun
Affiliation:
Department of Pediatric Cardiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
*
Correspondence to: Dr Tevfik Demir, AKÜ, Mavi Hastane, Izmir Yolu, PK: 03200, Afyonkarahisar/TURKEY. Tel: +9 0 532 372 0110(GSM); Fax: +9 0 212 581 26 80; E-mail: tevfikz@yahoo.com
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Abstract

Objective

Our aim was to investigate the change in diameter of holes within the oval fossa, and the role of aneurismal formation in reducing the size of the hole, in patients diagnosed during infancy with isolated defects in the floor of the fossa.

Patients

In a retrospective study, we included 100 patients diagnosed during the first year of life with an isolated defect in the floor of the oval fossa who had subsequently been observed for at least 5 years. There were 56 females and 44 males. They had been admitted to hospital because of a murmur in 65, heart failure in 9, and other reasons in 17. The remaining 9 patients were referred from other institutions with an established diagnosis of defects within the oval fossa. Patients were grouped according to the size of the deficiency in the floor of the fossa. Defects of diameter less than 5 mm were considered to be small, and 20 patients had such defects. Medium sized defects were judged to be between 5 and 8 mm, with 26 patients fulfilling this criterion, with the other 54 patients having large defects with diameters greater than 8 mm.

Results

The overall spontaneous rate of closure was 27%. Of those with medium defects, half closed spontaneously, but only 7.5% of those with large defects showed such closure. Of the patients who were diagnosed with heart failure, 9 had defects measuring 7 mm, and of these, 6 required surgical closure, 1 patient had spontaneous closure, while the defect became smaller in the remaining 2. On the other hand, in 9 out of 10 patients who had aneurysms, the diameter of the defect was between 7 and 15 mm. Amongst these patients, the defect closed spontaneously in 3, and reduced in size in the others.

Conclusion

When holes within the oval fossa measure 8 mm or below, the majority of patients with experience either spontaneous closure or show decrease in size of the defect. In those with larger defects, the size usually increases, and surgery is needed for closure. If there is aneurismal formation, however, even when the defect measures more than 8 mm, the defect usually closes on its own or gets smaller.

Keywords

Atrial septal defectoutcomeaneurysm
Type
Original Article
Information
Cardiology in the Young , Volume 18 , Issue 1 , February 2008 , pp. 75 - 78
Copyright
Copyright © Cambridge University Press 2008

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References

1. Ghisla, RP, Hannon, DW, Meyer, RA, Kaplan, S. Spontaneous closure of isolated secundum atrial septal defects in infants: an echocardiographic study. Am Heart J 1985; 109: 1327–1333.CrossRefGoogle ScholarPubMed
2. Cockerham, JT, Martin, TC, Gutierrez, FR, Hartmann, AF Jr, Goldring, D, Strauss, AW. Spontaneous closure of secundum atrial septal defect in infants and young children. Am J Cardiol 1983; 52: 1267–1271.CrossRefGoogle ScholarPubMed
3. Mahoney, LT, Truesdell, SC, Krzmarzick, TR, Lauer, RM. Atrial septal defects that present in infancy. Am J Dis Child 1986; 140: 1115–1118.Google ScholarPubMed
4. Mody, MR. Serial hemodynamic observations in secundum atrial septal defect with special reference to spontaneous closure. Am J Cardiol 1973; 32: 978–981.CrossRefGoogle ScholarPubMed
5. Radzik, D, Davignon, A, van Doesburg, N, Fournier, A, Marchand, T, Ducharme, G. Predictive factors for spontaneous closure of atrial septal defects diagnosed in the first 3 months of life. J Am Coll Cardiol 1993; 22: 851–853.CrossRefGoogle ScholarPubMed
6. Hoffman, JI, Rudolph, AM, Danilowicz, D. Left to right atrial shunts in infants. Am J Cardiol 1972; 30: 868–875.CrossRefGoogle ScholarPubMed
7. Hartmann, AF Jr, Elliott, LP. Spontaneous physiologic closure of an atrial septal defect after infancy. Am J Cardiol 1967; 19: 290–292.CrossRefGoogle ScholarPubMed
8. Gallet, B, Malergue, MC, Adams, C, et al. . Atrial septal aneurysm – a potential cause of systemic embolism. An echocardiographic study. Br Heart J 1985; 53: 292–297.CrossRefGoogle ScholarPubMed
9. Porter, CJ, Feldt, RH, Edward, WD, Seward, JB, Schaff, HV. Atrial septal defects. In: Moss, AJ, Adams, FH (eds). Heart Disease in Infants, Children, And Adolescents Including the Fetus and Young Adult. Lippincott Williams and Wilkins, Philadelphia, 2001, pp 603–617.Google Scholar
10. Helgason, H, Jonsdottir, G. Spontaneous closure of atrial septal defects. Pediatr Cardiol 1999; 20: 195–199.CrossRefGoogle ScholarPubMed
11. Azhari, N, Shihata, MS, Al-Fatani, A. Spontaneous closure of atrial septal defects within the oval fossa. Cardiol Young 2004; 14: 148–155.CrossRefGoogle ScholarPubMed
12. Cayler, GG. Spontaneous functional closure of symptomatic atrial septal defects. N Engl J Med 1967; 276: 65–73.CrossRefGoogle ScholarPubMed
13. Timmis, GC, Gordon, S, Reed, JO. Spontaneous closure of an atrial septal defect. Jama 1966; 196: 17–19.CrossRefGoogle ScholarPubMed
14. Fukazawa, M, Fukushige, J, Ueda, K. Atrial septal defects in neonates with reference to spontaneous closure. Am Heart J 1988; 116: 123–127.CrossRefGoogle ScholarPubMed
15. Senocak, F, Karademir, S, Cabuk, F, Onat, N, Koc, S, Duman, A. Spontaneous closure of interatrial septal openings in infants: an echocardiographic study. Int J Cardiol 1996; 53: 221–226.CrossRefGoogle ScholarPubMed
16. Ozcelik, N, Atalay, S, Tutar, E, Ekici, F, Atasay, B. The prevalence of interatrial septal openings in newborns and predictive factors for spontaneous closure. Int J Cardiol 2006; 108: 207–211.CrossRefGoogle ScholarPubMed
17. Riggs, T, Sharp, SE, Batton, D, Hussey, ME, Weinhouse, E. Spontaneous closure of atrial septal defects in premature vs. full-term neonates. Pediatr Cardiol 2000; 21: 129–134.CrossRefGoogle ScholarPubMed
18. Awan, IH, Rice, R, Moodie, DS. Spontaneous closure of atrial septal defect with interatrial aneurysm formation. Documentation by noninvasive studies, including digital subtraction angiography. Pediatr Cardiol 1982; 3: 143–145.CrossRefGoogle ScholarPubMed
19. Gondi, B, Nanda, NC. Two-dimensional echocardiographic features of atrial septal aneurysm. Circulation 1981; 63: 452–457.CrossRefGoogle Scholar
20. Edward, JE. Congenital malformations of the heart and great vessels. A Malformation of the atrial septal complex. In: Gould, SE (ed). Pathology of the Heart. Charles C Thomas, Springfield, Illinois, 1960, pp 260–293.Google Scholar
21. Brand, A, Keren, A, Branski, D, Abrahamov, A, Stern, S. Natural course of atrial septal aneurysm in children and the potential for spontaneous closure of associated septal defect. Am J Cardiol 1989; 64: 996–1001.CrossRefGoogle ScholarPubMed
22. Ozcelik, N, Atalay, S, Tutar, E, Ekici, F. Prevalence of interatrial septal aneurysm in newborns and their natural course. Pediatr Cardiol 2006; 27: 343–346.CrossRefGoogle ScholarPubMed
23. Shiraishi, I, Hamaoka, K, Hayashi, S, Koh, E, Onouchi, Z, Sawada, T. Atrial septal aneurysm in infancy. Pediatr Cardiol 1990; 11: 82–85.CrossRefGoogle ScholarPubMed