Table 1

Atrial septal defects: classification and follow-up

AuthorPopulationASD definition/size groupNatural historySuggested follow-up
McMahon, Texas8125 children, mean age 4.5 years (0.1–71 years)
F-up: 3.1  years (0.7–8.1 years)
Group 1 Small: 34 pts, 3–6 mm
Group 2 Moderate: 40 pts, 6–12 mm
Group 3 Large: 30 pts, ≥12 mm		All: bigger in 66%* smaller in 14%, unchanged in 20%
Group 1: 3 close, 17 smaller, 10 bigger
Group 2: 3 smaller, 8 bigger
Group 3: all bigger or unchanged
Garne, Denmark1078 infants ASD, 195 VSD, 19 ASD+VSD
5 weeks-15 months†		61 isolated ASD8% surgery <5 years, 7
0% SC <1 year		F-up every 2 years after age 15 months
Riggs, Michigan1282 newborns (38 premature and 44 term)
Preterm infants, 11±9 days (range 1–26); f-up: 450±530 days.
Term infants
3±5 days (range 1–26); f-up: 135±190 days.		Group 1: 23 pts, <3 mm
Group 2 : 29 pts, 3–5 mm
Group 3: 30 pts, 5–7 mm
Class A <5 mm; class B >5 mm		Median SC times (days): Group 1: 370; Group 2: 136; Group 3: 501
ASD size with weak effect on closure rate (p 40.22); class A and B ASD size with significant effect (p 40.038)
Helgason, Iceland1391 children, mean age 12.1±13 months.‡Group 1: 29 pts, 4 mm
Group 2: 17 pts, 5–6 mm
Group 3: 8 pts, 7–8 mm
Group 4: 6 pts, >8 mm		Group 1: SC or smaller 89%; surgery 1 pt
Group 2: SC 79%; surgery 2 pts
Group 3: SC 16.6%; surgery 3 pts
Group 4: SC <1%; surgery 91%

  • *Rate of increase: 0.8 mm/year (0.2–6.4 mm/year).

  • †Incidence 4.1/1000 live births.

  • ‡Incidence 2.1/1000 live births.

  • ASD, atrial septal defect; f-up, follow-up; SC, spontaneous closure; VSD, ventricular septal defect.