J Korean Pediatr Soc.  2002 May;45(5):609-614.

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

• Hwang YJ
• Chung KH
• Choi SM
• Lee KH

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.

Keyword

Atrial Septal Defect; Spontaneous Closure

MeSH Terms

Axis, Cervical Vertebra
Diagnosis
Female
Heart Septal Defects, Atrial*
Humans
Male