Frequency of severe pulmonary hypertension complicating "isolated" atrial septal defect in infancy

Goetschmann, Sora; Dibernardo, Stefano; Steinmann, Hildegard; Pavlovic, Mladen; Sekarski, Nicole; Pfammatter, Jean-Pierre (2008). Frequency of severe pulmonary hypertension complicating "isolated" atrial septal defect in infancy. American journal of cardiology, 102(3), pp. 340-2. New York, N.Y.: Elsevier 10.1016/j.amjcard.2008.03.061

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Atrial septal defects (ASDs) are typically asymptomatic in infancy and early childhood, and elective defect closure is usually performed at ages of 4 to 6 years. Severe pulmonary hypertension (PH) complicating an ASD is seen in adulthood and has only occasionally been reported in small children. A retrospective study was undertaken to evaluate the incidence of severe PH complicating an isolated ASD and requiring early surgical correction. During a 10-year period (1996 to 2006), 355 pediatric patients underwent treatment for isolated ASDs either surgically or by catheter intervention at 2 tertiary referral centers. Two hundred ninety-seven patients had secundum ASDs, and 58 had primum ASDs with mild to moderate mitral regurgitation. Eight infants were found with isolated ASDs (6 with secundum ASDs and 2 with primum ASDs) associated with significant PH, accounting for 2.2% of all patients with ASDs at the centers. These 8 infants had invasively measured pulmonary artery pressures of 50% to 100% of systemic pressure. They were operated in the first year of life and had complicated postoperative courses requiring specific treatment for PH for up to 16 weeks postoperatively. The ultimate outcomes in all 8 infants were good, with persistent normalization of pulmonary pressures during midterm follow-up of up to 60 months (median 28). All other patients with ASDs had normal pulmonary pressures, and the mean age at defect closure was significantly older, at 6.2 years for secundum ASDs and 3.2 years for primum ASDs. In conclusion, ASDs were rarely associated with significant PH in infancy but then required early surgery and were associated with excellent midterm outcomes in these patients.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
UniBE Contributor:	Götschmann, Sora, Pavlovic, Mladen, Pfammatter, Jean-Pierre
ISSN:	0002-9149
ISBN:	18638598
Publisher:	Elsevier
Language:	English
Submitter:	Anette van Dorland
Date Deposited:	04 Oct 2013 15:03
Last Modified:	05 Dec 2022 14:19
Publisher DOI:	10.1016/j.amjcard.2008.03.061
PubMed ID:	18638598
Web of Science ID:	000258012800017
URI:	https://boris.unibe.ch/id/eprint/27228 (FactScience: 105087)