Skip to main content
SpringerLink
Log in

Long-term Outcome after Surgical Closure of Atrial Septal Defect in Childhood with Extensive Assessment Including MRI Measurement of the Ventricles

  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

Surgical closure of the secundum type of atrial septal defect (ASD) in childhood leads to excellent survival. However, relevant morbidity has been reported. Transcatheter closure of these defects has now become an alternative approach. To compare the results of the two different interventions, reliable data are needed on the long-term morbidity after defect closure with both methods. Patients were evaluated after a minimum of 10 years after surgical closure of an ASD in childhood. Assessment included analysis of perioperative data, interview, clinical examination, electrocardiogram, (ECG), 24-hour ECG, ergometry, chest radiograph, echocardiography, and MRI. A total of 66 patients underwent operation between 1971 and 1986 at our institution. Forty-eight of them (73%) were interviewed and 38 (58%) participated fully in the study program. Eighteen (27%) either refused to participate or were lost to follow-up. There were no substantial residual disorders, such as arrhythmias, right-sided heart dilatation, pulmonary hypertension, or reduced work capacity. Surgical closure of an ASD in childhood has an excellent long-term outcome. Surgical closure is thus the standard against which transcatheter closure needs to be measured.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. E Besterman (1961) ArticleTitleAtrial septal defect with pulmonary hypertension Br Heart J 23 587–598 Occurrence Handle1:STN:280:DC%2BD1crjtFKjuw%3D%3D Occurrence Handle18610164

    CAS  PubMed  Google Scholar 

  2. MTE Bink-Boelkens KJ Meuzelaar A Eygelaar (1988) ArticleTitleArrhythmias after repair of secundum atrial septal defect: the influence of surgical modification Am Heart J 115 629–632 Occurrence Handle3344661 Occurrence Handle10.1016/0002-8703(88)90814-9 Occurrence Handle1:STN:280:DyaL1c7kslOktA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  3. M Bolens B Friedli (1984) ArticleTitleSinus node function and conduction system before and after surgery for secundum atrial septal defect: an electrophysiologic study Am J Cardiol 53 1415–1420 Occurrence Handle6720586 Occurrence Handle10.1016/S0002-9149(84)90825-7 Occurrence Handle1:STN:280:DyaL2c7pvF2luw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  4. G Cherian CB Uthaman M Durairaj et al. (1983) ArticleTitlePulmonary hypertension in isolated secundum atrial septal defect: high frequency in young patients Am Heart J 105 952–957 Occurrence Handle6858843 Occurrence Handle1:STN:280:DyaL3s3islyhsQ%3D%3D

    PubMed  CAS  Google Scholar 

  5. ZD Du ZM Hijazi CS Kleinmann NH Silvermann K Larntz (2002) ArticleTitleComparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults J Am Coll Cardiol 39 1836–1844 Occurrence Handle12039500

    PubMed  Google Scholar 

  6. RG Fraser JAP Paré PD Paré RS Fraser GP Genereux (1988) The heart D Manke (Eds) Diagnosis of diseases of the chest; Vol 1 W.B. Saunders Philadelphia 252–253

    Google Scholar 

  7. Galal MO, von Bremen K, Sekarski N (2001) Cost-comparison of transcatheter and surgical closure of atrial septal defect in children [abstr]. Proceedings of the 3rd World Congress of Pediatric Cardiology and Cardiac Surgery, Toronto, Canada, p 878

  8. KWE Groundstroem TE livainen T Talvensaari JT Lahtela (1999) ArticleTitleLate postoperative follow-up of ostium secundum defect Eur Heart J 20 904–909 Occurrence Handle10329097 Occurrence Handle10.1053/euhj.1998.1349 Occurrence Handle1:STN:280:DyaK1M3mt1CjsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  9. SG Haworth (1983) ArticleTitlePulmonary vascular disease in secundum atrial septal defect in childhood Am J Cardiol 51 265–272 Occurrence Handle6823835 Occurrence Handle1:STN:280:DyaL3s7itlOmug%3D%3D

    PubMed  CAS  Google Scholar 

  10. ML Hughes G Maskell TH Goh JL Wilkinson (2002) ArticleTitleProspective comparison of costs and short term health outcome of surgical versus transcatheter closure of atrial septal defect in children Heart 88 67–70 Occurrence Handle12067948 Occurrence Handle10.1136/heart.88.1.67 Occurrence Handle1:STN:280:DC%2BD38zisFWnuw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  11. FW James S Kaplan CJ Glueck et al. (1980) ArticleTitleResponses of normal children and young adults to controlled bicycle exercise Circulation 61 902–912 Occurrence Handle7363434 Occurrence Handle1:STN:280:DyaL3c7lsFGntg%3D%3D

    PubMed  CAS  Google Scholar 

  12. JD Kugler (1990) Sinus node dysfunction A Garson JT Bricker I McNamara (Eds) The science and practice of pediatric cardiology EditionNumber1st ed. Lea & Fabiger Philadelphia/London 1751–1785

    Google Scholar 

  13. J Mandelik DS Moodie R Sterba et al. (1994) ArticleTitleLong-term follow-up of children after repair of atrial septal defects Cleve Clin J Med 61 29–33 Occurrence Handle8124844 Occurrence Handle1:STN:280:DyaK2c7ntVGitQ%3D%3D

    PubMed  CAS  Google Scholar 

  14. F Meijboom J Hess A Szatmari et al. (1993) ArticleTitleLong-term follow-up (9 to 20 years) after surgical closure of atrial septal defect at a young age Am J Cardiol 72 1431–1434 Occurrence Handle8256739 Occurrence Handle10.1016/0002-9149(93)90192-F Occurrence Handle1:STN:280:DyaK2c%2FnvV2itA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  15. RA Meyer JC Korfhagen W Covitz S Kaplan (1982) ArticleTitleLong-term follow-up study after closure of secundum atrial septal defect in children: an echocardiographic study Am J Cardiol 50 143–148 Occurrence Handle7090997 Occurrence Handle10.1016/0002-9149(82)90020-0 Occurrence Handle1:STN:280:DyaL383islCmsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  16. CD Morris VD Menashe (1991) ArticleTitle25-year mortality after surgical repair of congenital heart defect in childhood JAMA 266 3447–3452 Occurrence Handle1744959 Occurrence Handle10.1001/jama.266.24.3447 Occurrence Handle1:STN:280:DyaK38%2FnvFeguw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  17. JG Murphy BJ Gersh MD McGoon et al. (1990) ArticleTitleLong-term outcome after surgical repair of isolated atrial septal defect N Engl J Med 323 1645–1650 Occurrence Handle2233961 Occurrence Handle1:STN:280:DyaK3M%2Fkt12itQ%3D%3D

    PubMed  CAS  Google Scholar 

  18. JS Pastorek HD Allen D Terrance (1994) ArticleTitleCurrent outcomes of surgical closure of secundum atrial septal defect Am J Cardiol 74 75–77 Occurrence Handle8017313 Occurrence Handle10.1016/0002-9149(94)90498-7 Occurrence Handle1:STN:280:DyaK2c3osl2gsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  19. P Puech H Latour G Olivier G Giraud (1960) ArticleTitleL’hypertension arterielle pulmonaire primitive. II. Association à la communication interauriculaire Arch Mal Coeur Vaiss 53 291–315 Occurrence Handle14435251 Occurrence Handle1:STN:280:DyaF3c7osl2rsg%3D%3D

    PubMed  CAS  Google Scholar 

  20. JM Reid JC Stevenson (1967) ArticleTitleCardiac arrhythmias following successful surgical closure of atrial septal defect Br Heart J 29 742–747 Occurrence Handle6039169 Occurrence Handle1:STN:280:DyaF2s3kt1yjtg%3D%3D

    PubMed  CAS  Google Scholar 

  21. MB Rominger GF Bachmann W Pabst WS Rau (1999) ArticleTitleRight ventricular volumes and ejection fraction with fast cine MR imaging in breath-hold technique: applicability, normal values from 52 volunteers, and evaluation of 325 adult cardiac patients J Magn Reson Imaging 10 908–918 Occurrence Handle10581503 Occurrence Handle10.1002/(SICI)1522-2586(199912)10:6<908::AID-JMRI2>3.0.CO;2-2 Occurrence Handle1:STN:280:DC%2BD3c%2FltVemsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  22. JW Roos-Hesselink FJ Meijboom SEC Spitaels et al. (2003) ArticleTitleExcellent survival and low incidence of arrhythmias, stroke and heart failure long-term after surgical ASD closure at young age: a prospective follow-up study of 21–33 years Eur Heart J 24 190–197 Occurrence Handle12573276 Occurrence Handle10.1016/S0195-668X(02)00383-4 Occurrence Handle1:STN:280:DC%2BD3s%2FmtlCksA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  23. H Rostad SJ Sørland (1981) ArticleTitleAtrial septal defects of secundum type in patients less than 40 years of age: a follow-up study Acta Med Scand 645 IssueID(Suppl): 29–35 Occurrence Handle1:STN:280:DyaL3M3gtlOksQ%3D%3D

    CAS  Google Scholar 

  24. DG Ruschhaupt L Khoury OG Thilenius RL Replogle RA Arcilla (1984) ArticleTitleElectrophysiologic abnormalities of children with ostium secundum atrial septal defect Am J Cardiol 53 1643–1647 Occurrence Handle6731310 Occurrence Handle10.1016/0002-9149(84)90594-0 Occurrence Handle1:STN:280:DyaL2c3ivVansQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  25. I Schnittger EP Gordon PJ Fitzgerald RL Popp (1983) ArticleTitleStandardized intracardiac measurements of two-dimensional echocardiography J Am Coll Cardiol 2 934–938 Occurrence Handle6630768 Occurrence Handle1:STN:280:DyaL2c%2FjtlOjuw%3D%3D Occurrence Handle10.1016/S0735-1097(83)80242-3

    Article  PubMed  CAS  Google Scholar 

  26. B Stöver (1986) ArticleTitleDetermination of heart size and measurements of blood vessels in chest imaging of 4-to 15-year-old children with a healthy cardiovascular system Radiologe 26 259–265 Occurrence Handle3749499

    PubMed  Google Scholar 

  27. JD Thomson EH Aburawi KG Watterson C Doorn ParticleVan JL Gibbs (2002) ArticleTitleSurgical and transcatheter (Amplatzer) closure of atrial septal defects: a prospective comparison of results and cost Heart 87 466–469 Occurrence Handle11997423 Occurrence Handle10.1136/heart.87.5.466 Occurrence Handle1:STN:280:DC%2BD383lslOrsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  28. KJ Visconti DP Bichell RA Jonas JW Newburger DC Bellinger (1999) ArticleTitleDevelopmental outcome after surgical versus interventional closure of secundum atrial septal defect in children Circulation 100 IssueID(19 Suppl): II145–150 Occurrence Handle10567294 Occurrence Handle1:STN:280:DC%2BD3c%2FjslSgsA%3D%3D

    PubMed  CAS  Google Scholar 

  29. D Young (1973) ArticleTitleLater results of closure of secundum atrial septal defect in children Am J Cardiol 31 14–22 Occurrence Handle4682405 Occurrence Handle10.1016/0002-9149(73)90804-7 Occurrence Handle1:STN:280:DyaE3s%2FmsFGnuw%3D%3D

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

We are indebted to Christian Schindler for the statistical analysis.

Author information

Authors and Affiliations

  1. Division of Cardiology, University Children’s Hospital, Roemergasse 8, 4005, Basel, Switzerland

    D. Bolz & J. Guenthard

  2. Department of Radiology, University Hospital, Petersgraben 4, 4031, Basel, Switzerland

    T. Lacina

  3. Division of Cardiology, University Hospital, Petersgraben 4, 4031, Basel, Switzerland

    P. Buser & M. Buser

Authors
  1. D. Bolz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Lacina
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Buser
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Buser
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Guenthard
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D. Bolz.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bolz, D., Lacina, T., Buser, P. et al. Long-term Outcome after Surgical Closure of Atrial Septal Defect in Childhood with Extensive Assessment Including MRI Measurement of the Ventricles. Pediatr Cardiol 26, 614–621 (2005). https://doi.org/10.1007/s00246-005-0838-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-005-0838-2

Keywords

Search

Navigation