| Clinical Course of the Ostium Secundum Atrial Septal Defect(ASD) and Its Rate of Spontaneous Closure |
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Dae Yong Kim, Myung Chul Hyun, Sang Bum Lee |
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Department of Pediatrics, Kyungpook National University, College of MedicineTaegu, Korea |
| 심방중격결손(ASD)의 임상 경과와 자연폐쇄 |
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김대용, 현명철, 이상범 |
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경북대학교 의과대학 소아과학교실 |
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| Abstract |
Purpose
: To know the natural course of the ostium secundum ASD including its rate of
spontaneous closure.
Methods
: We studied 259 cases who were diagnosed as ostium secundum ASD by
2D-echocardiography at Department of Pediatrics, Kyungpook National University Hospital
between Jan. 1985 and Dec. 1994. According to the age at diagnosis, we divided them into
two groups, group I (those diagnosed before 1 month of age: 59 cases) and group II (those
diagnosed after 1 month of age: 200 cases)
Results
: Mean age at first diagnosis was 2.6¡¾4.6 years and mean defect size(diameter by
2D-echocardiography) was 9.9¡¾8.0 mm. Cardiac murmur was the main reason to refer the
patients to hospital, being in 50 cases(87%) in group I, 179 cases(90%) in group II. Defect
sizes were significantly small in group I compared with group II (5.3¡¾3.4 mm vs 11.1¡¾6.9
mm, p<0.05). Symptoms corresponding to congestive heart failure were present in 16 cases of
group I (27%)( isolated ASD: 8 cases, ASD accompanying with PDA: 5 cases, ASD
accompanying with VSD: 2 cases, ASD accompanying both PDA and VSD : 1 case) and in 27
cases of group II(13.5%) (isolated ASD: 17 cases, ASD accompanying with VSD: 4 cases,
ASD accompanying with PDA: 4 cases, ASD accompanying both PDA and VSD: 2 cases).
Of total 139 cases, spontaneous closure of ostium secundum ASD was documented in 14
cases(10.1%) by follow up 2D-echocardiography. The rate of spontaneous closure was
significantly high in group I compared with group II (6 cases: 37.5% vs 8 cases: 6.5%,
p<0.05) Comparing with those cases without closure, there were no significant differences in
defect size in group I but significant differences in group II(p<0.05), being 5.63¡¾2.62 mm in
cases with spontaneous closure and 12.82¡¾7.09 mm in those cases without closure. Of the 9
cases with atrial septal septal aneurysm, 2D- echocardiographic follow ups were possible in 5
cases with spontaneous closure in 2 (40%).
Conclusion
: Spontaneous closure was documented in 10.1% of all the patients with ostium
secundum ASD. Especially the closure rate was significantly high in those cases their diagnosis
was made before 1 month of age and with atrial septal aneurysm. |
| Key Words:
Ostium secundum atrial septal defect(ASD), Spontaneous closure |
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