| Transcatheter Closure of Secundum Atrial Septal Defect in Infants Less than 12 Months of Age Improves Symptoms of Chronic Lung Disease. | |
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MedLine Citation:
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PMID: 21443579 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Objective. Device closure of secundum type atrial septal defects in young children has now become common with extension of this practice to children less than 1 year of age. We hypothesized that patients less than 12 months of age with moderate increases in pulmonary blood flow due to atrial septal defects may improve clinically with device closure, particularly premature infants with chronic lung disease. Design. Thirteen patients under 12 months of age have undergone atrial septal device closure at our institution from March 2002 to July 2008, with evidence of a left to right shunt by pre-procedural echocardiogram. We evaluated concomitant conditions and device closure results. Patient charts from follow-up visits with referring pediatric cardiologists were also reviewed. Follow-up phone interviews were conducted with parents/guardians of patients who underwent device closure to further evaluate clinical change. Results. The patient ages ranged from 3-11 months (median 7) with weight ranges of 2.9-8.3 kg (median 6.5). Defect sizes ranged from 5-15 mm (median 9). Concomitant conditions included prematurity with bronchopulmonary dysplasia (n = 8) and concern of elevated pulmonary artery pressures (n = 5). The median Qp : Qs was 1.6 with a range of 1 to 2.6. The mean pulmonary artery pressures ranged from 16 to 55 mm Hg (median 27). Eleven of 13 patients showed significant improvement in their clinical status, with a reduction in oxygen requirement (six patients) and reduced right heart pressures by echocardiogram (four patients). There were no residual defects on follow-up echocardiograms. Conclusion. Transcatheter closure of atrial septal defects in infants can be safe, effective, and may be indicated for situations in which the left to right shunt may be implicated as a cause of ongoing chronic lung disease. Moderate increases in pulmonary blood flow due to atrial septal defects may have a negative clinical impact regarding continuing respiratory insufficiency in these patients. |
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Authors:
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Vincent C Thomas; Robert Vincent; Anthony Raviele; Helen Diehl; Holly Qian; Dennis Kim |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-28 |
Journal Detail:
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Title: Congenital heart disease Volume: - ISSN: 1747-0803 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-3-29 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101256510 Medline TA: Congenit Heart Dis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011 Copyright the Authors. Congenital Heart Disease © 2011 Wiley Periodicals, Inc. |
Affiliation:
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Emory University Children's Healthcare of Atlanta, Pediatric Cardiology, Atlanta, Georgia, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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