Evaluation of intracardial hemodynamics in children under 1 year of age with atrial septal defect
https://doi.org/10.24835/1607-0763-1448
Abstract
Aim: evaluation of the intracardiac hemodynamics and determination indications for early correction of the atrial septal defect in children before 1 year age.
Methods. The study included patients observed from 2010 to 2021. The first group was formed from children under the age of 12 months with ASD and were observed for the next 4 years until its interventional or surgical elimination. The second group included healthy children of the appropriate age. All patients underwent an echocardiographic (ECHO) study with assessment of the main parameters of hemodynamics and intracardial structures.
Results. The first group included 887 children with ASD, the control group included 887 healthy children. The age of the patients included in the study was 6 ± 2.6 months. for group I and 6 ± 2.5 months. for the second one. It was found that in young children with ASD, the first manifestation of hemodynamic changes was dilatation of the right ventricle, then the right atrium and finally dilatation of the pulmonary trunk, which was accompanied by an increase in pressure in the pulmonary circulation and weight loss. In 11% of patients, spontaneous closure of the ASD occurs within the first year of life. Almost 20% of patients are younger than 6 months. have clinical and hemodynamic indications for surgical treatment of ASD.
Conclusions. Indications for the atrial septal defect closure should be determined taking into account clinical, anatomical and hemodynamic parameters.
About the Authors
A. A. Sokolov
Cardiology research Institute, Tomsk National medical research Center of the Russian Academy of Sciences
Russian Federation
Russian Federation
Alexander A. Sokolov – Doct. of Sci. (Med.), Professor, Head of the Department of Functional and Laboratory Diagnostics, Cardiology research Institute, Tomsk National medical research Center of the Russian Academy of Sciences, Tomsk
О. A. Egunov
Cardiology research Institute, Tomsk National medical research Center of the Russian Academy of Sciences
Russian Federation
Russian Federation
Оleg A. Egunov – Cand. of Sci. (Med.), cardiovascular surgeon, researcher, Department of Cardiovascular Surgery, Cardiology research Institute, Tomsk National medical research Center of the Russian Academy of Sciences, Tomsk
A. V. Smorgon
Cardiology research Institute, Tomsk National medical research Center of the Russian Academy of Sciences
Russian Federation
Russian Federation
Andrey V. Smorgon – Junior Researcher, employee of the laboratory of ultrasound and functional research methods, Cardiology research Institute, Tomsk National medical research Center of the Russian Academy of Sciences, Tomsk
R. S. Kozhanov
Cardiology research Institute, Tomsk National medical research Center of the Russian Academy of Sciences
Russian Federation
Russian Federation
Roman S. Kozhanov – postgraduate student of the Department of Cardiovascular Surgery, cardiovascular surgeon, Cardiology research Institute, Tomsk National medical research Center of the Russian Academy of Sciences, Tomsk
References
1. Bokeria L.A., Kim A.I., Zelenikin M.M. et al. Atrial septal defect. Clinical guidelines 2023. Russian Journal of Cardiology. 2023; 28 (8): 5588. https://doi.org/10.15829/1560-4071-2023-5588 (In Russian)
2. Silvestry F.E., Cohen M.S., Armsby L.B. et al.; American Society of Echocardiography; Society for Cardiac Angiography and Interventions. Guidelines for the Echocardiographic Assessment of Atrial Septal Defect and Patent Foramen Ovale: From the American Society of Echocardiography and Society for Cardiac Angiography and Interventions. J. Am. Soc. Echocardiogr. 2015; 28: 910–958. http://doi.org/10.1016/j.echo.2015.05.015
3. Martin S.S., Shapiro E.P., Mukherjee M. Atrial septal defects – clinical manifestations, echo assessment, and intervention. Clin. Med. Insights Cardiol. 2015; 8 (Suppl. 1): 93–98. http://doi.org/10.4137/CMC.S15715
4. Lammers A., Hager A., Eicken A. et al. Need for closure of secundum atrial septal defect in infancy. J. Thorac. Cardiovasc. Surg. 2005; 129 (6):1353–1357. http://doi.org/10.1016/j.jtcvs.2004.10.007
5. Alkashkari W., Albugami S., Hijazi Z.M. Current practice in atrial septal defect occlusion in children and adults. Expert Rev. Cardiovasc. Ther. 2020; 18 (6): 315–329. http://doi.org/10.1080/14779072.2020.1767595
6. Ye Z., Li Z., Yi H. et al. Optimization of echo views for percutaneous device closure of pediatric atrial septal defect through the femoral vein guided by transthoracic echocardiography without radiation. J. Interv. Cardiol. 2020: 8242790. http://doi.org/10.1155/2020/8242790
7. Baranov A.A., Shhepljagin L.A. Physiology of growth and development of children and adolescents (theoretical and clinical issues). M.: GOTAR-MED, 2006. 2 vol. (In Russian)
8. Zhizhin K.S. Medical statistics. Feniks, 2007. 160 p. (In Russian)
9. Chinawa J.M., Chinawa A.T., Ossai E.N., Duru C.O. Predictors of pulmonary hypertension among children with atrial septal defects (ASD). Libyan J. Med. 2022; 17 (1): 2007603. http://doi.org/10.1080/19932820.2021.2007603
10. Hanslik A., Pospisil U., Salzer-Muhar U. et al. Predictors of spontaneous closure of isolated secundum atrial septal defect in children: a longitudinal study. Pediatrics. 2006; 118 (4): 1560–1565. http://doi.org/10.1542/peds.2005-3037
11. Azhari N., Shihata M.S., Al-Fatani A. Spontaneous closure of atrial septal defects within the oval fossa. Cardiol. Young. 2004; 14 (2): 148–155. http://doi.org/10.1017/S1047951104002069
12. Ostermayer S.H., Srivastava S., Doucette J.T. et al. Malattached septum primum and deficient septal rim predict unsuccessful transcatheter closure of atrial communications. Catheter Cardiovasc. Interv. 2015; 86 (7): 1195–1203. http://doi.org/10.1002/ccd.26102
13. Wang S.Y., Welch T.D., Elfenbein A., Kaplan A.V. Spontaneous Closure of a Secundum Atrial Septal Defect. Methodist Debakey Cardiovasc J. 2018; 14 (1): 60–62. http://doi.org/10.14797/mdcj-14-1-60
14. Butera G., De Rosa G., Chessa M. et al. Transcatheter closure of atrial septal defect in young children: results and follow-up. J. Am. Coll. Cardiol. 2003; 42 (2): 241–245. http://doi.org/10.1016/s0735-1097(03)00589-8
15. Tanghöj G., Liuba P., Sjöberg G., Naumburg E. Predictors of the need for an atrial septal defect closure at very young age. Front Cardiovasc Med. 2020; 6: 185. http://doi.org/10.3389/fcvm.2019.00185
16. Chessa M., Carminati M., Butera G. et al. Early and late complications associated with transcatheter occlusion of secundum atrial septal defect. J. Am. Coll. Cardiol. 2002; 39 (6): 1061–1065. http://doi.org/10.1016/s0735-1097(02)01711-4
17. Dafni D., Bini R.M., Riley G. et al. Repair of isolated atrial septal defect in infants less than 12 months improves symptoms of chronic lung disease or shunt-related pulmonary hypertension. Cardiol. Young. 2020; 30 (4): 511–520. http://doi.org/10.1017/S1047951120000463
18. Tsuda T., Davies R.R., Radtke W. et al. Early surgical closure of atrial septal defect improves clinical status of symptomatic young children with underlying pulmonary abnormalities. Pediatr. Cardiol. 2020; 41 (6): 1115–1124. http://doi.org/10.1007/s00246-020-02361-8
Supplementary files
Review
For citations:
Sokolov A.A., Egunov О.A., Smorgon A.V., Kozhanov R.S. Evaluation of intracardial hemodynamics in children under 1 year of age with atrial septal defect. Medical Visualization. 2024;28(3):99-105. (In Russ.) https://doi.org/10.24835/1607-0763-1448
Views:
233
Email this article 