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Natural Course of Atrial Septal Defect Diagnosed Within the First 4 Weeks of Life

Journal of the Korean Pediatric Society 2002;45(5):609-614.
Published online May 15, 2002.
Natural Course of Atrial Septal Defect Diagnosed Within the First 4 Weeks of Life
Young Jun Hwang, Kyung Hyun Chung, Suk Min Choi, Kyu Hyung Lee
Department of Pediatrics, College of Medicine, Pochon CHA University, Bundang CHA General Hospital, Sungnam, Korea
4주 이하 신생아에서 진단된 심방중격결손의 자연경과에 관한 연구
황영준, 정경현, 최석민, 이규형
포천중문의과대학 분당차병원 소아과
Correspondence: 
Suk Min Choi, Email: jenny99@hananet.net
Abstract
Purpose
: The purpose of our investigation was to explore the natural course, and the factors that influence the natural course, in ostium secundum atrial septal defect(ASD) diagnosed within the first 4 weeks of life.
Methods
: We studied patients with ASD diagnosed within the first 4 weeks of life during the period from September 1995 to September 1999 in our hospital. The diagnosis and measuring of the size of ASD was carried out by two-dimensional echocardiogram(2DE, Hewlett-Packard Sonos 2500 ) from subcostal long and short axis views.
Results
: There were 61 patients - 29 males and 32 females. According to the size of their defects, we divided them into four groups; group A(less than 4 mm : 24 cases), group B(four mm- six mm : 27 cases), group C(six mm-eight mm : six cases), group D(more than eight mm : four cases). In groups A and B, 22 of 24 patients(91.7%) and 23 of 27 patients(85.2%) had each closed spontaneously. In group C, four of six patients had closed spontaneously. In group D, no patient had closed spontaneously and three of four patients had been closed surgically. There were significant differences in the rate of spontaneous closure between less than six mm group and more than six mm group in the size of the defect(P<0.05). There were no significant differences in the rate of spontaneous closure between ASD combined with simple cardiac defect and isolated secundum ASD.
Conclusion
: We conclude that defects smaller than six mm in diameter are very likely to close spontaneously.
Key Words: Atrial Septal Defect, Spontaneous Closure


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