篇名 | Predictors for Regression of Large Secundum Atrial Septal Defects Diagnosed in Infancy |
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卷期 | 29:1 |
作者 | Kuan-Miao Lin 、 Chi-Di Liang 、 Shao-Ju Chien 、 Ying-Jui Lin 、 I-Chun Lin 、 Mao-Hung Lo 、 Ting-Hsin Wu 、 Chien-Fu Huang |
頁次 | 082-087 |
關鍵字 | Infancy 、 Large secundum atrial septal defect 、 Natural course 、 Spontaneous closure 、 MEDLINE 、 SCI 、 Scopus |
出刊日期 | 201301 |
Purpose: To determine predictive factors of spontaneous closure or size reduction in large secundum-type atrial septal defects (ASD) diagnosed in infancy prior to catheterization or surgical intervention.
Methods: From June 2003 to October 2009, 59 infants diagnosed with secundum-type ASDs measuring 8mm in the first year of life were retrospectively enrolled. We reviewed medical records, as well as electrocardiography and echocardiography findings. Patients were divided into 2 groups according to the last ASD size: group A (n = 23), ASD reduction in size to < 5 mm or spontaneous closure; group B (n = 36), size of ASD remained 5 mm.
Results: The ASDs spontaneously closed in 10 (17%) patients at a median age of 26.0 5.1 months (range, 15-58 months), or decreased to < 5 mm in 13 (22%) (range, 6-27 months) patients. There was a significant difference in age at diagnosis between the 2 groups (p = 0.014). Patients in group A were younger than those in group B at the time of diagnosis. Changes in ASD size (p < 0.001) and body weight percentile (p = 0.01) were also significantly different fromthe 6-month follow-up. ASD diameter of 10mmwas a negative predictive factor for size reduction (p = 0.017).
Conclusions: Spontaneous closure or size reduction of large ASDs was not uncommon in patients diagnosed during infancy. Patients with initial ASD sizes between 8 and 10 mm who were younger at the time of diagnosis and showed better weight gain were more likely to have favorable outcomes.