The Natural Course and Size Change of Atrial Septal Defect Secundum

Choi, Deok Young; Choi, Jae Young; Kim, Mi Jin; Sul, Jun Hee; Lee, Sung Kyu

Abstract

PURPOSE
This study was performed to follow the natural course and size change of isolated atrial septal defect(ASD) secundum.
METHODS
Among the newly diagnosed with ASD secundum at the division of pediatric cardiology in Yonsei cardiovascular hospital from January 1996 to December 2000, 89 patients with pure ASD secundum were checked by the serial echocardiographic evaluation to measure the size change.
RESULTS
There was a statistical difference(P<0.05) in the rate of spontaneous closure and size change of the defect between the group of bigger defect(>8 mm) and the group of smaller defect (< or = 8 mm). There was also a statistical difference(P<0.05) in the rate of spontaneous closure and size change of the defect between the group of younger than three years of age and the group of older than three years of age. The initial size of the defect and change of size were the significant influencing factors in the rate of spontaneous closing of ASD. In the group of patients who have persistent ASD, the size of defect showed a tendency of increasing size of defect with the age(P<0.005); however in the correction of these values by the body surface area of each patients, there was no statistical difference.
CONCLUSION
The possibility of spontaneous closure of pure ASD secundum was higher in the group of patients who have smaller defect and who were younger. The ASD secundum that did not have spontaneous closure showed an increase in size with the growth of the patients; however when this size was corrected by the body surface area, there was no statistical difference. The closure of the defect was at 26.2 months of age so close follow-up of the patients is important.