G11 Isolated secundum ASD (atrial septal defect) – size matters!. (25th October 2020) - Hatata, A
Abstract : Introduction: Secundum ASD (Atrial Septal Defect) is a frequent often incidental finding during neonatal echocardiography. It might be associated with other congenital heart defects or can be an isolated finding. The smaller ASDs often close spontaneously and the larger ones often persists and may need surgery. The reported spontaneous closure rates for ASDs are between 14–66% in infants. Aim: To look at the outcomes and need for surgery, for different sizes of isolated secundum ASDs. Methods: Retrospective analysis of case notes of children presenting to the PEC (Paediatrician with expertise in cardiology) clinic following diagnosis of secundum ASD in the neonatal period between 2014 and 2019. Results: 153 cases of secundum ASDs were identified of which 133 were considered to be appropriate and 20 discarded. Of these 20 cases, five were lost to follow up, 5 were diagnosed to be PFO (Patent Foramen Ovale) and 10 had other defects or were not diagnosed in the neonatal age group. Of the 133 cases: 93 were <3 mm, 23 were between 3–5 mm and 17 were more than 5 mm on 2D measurement on echocardiography at diagnosis. The cases were roughly followed up every 6 monthly intervals in the PEC clinic. The closure rate noted were as follows: Discussion: Secundum ASDs are often a common finding in neonatal echocardiography. Our study showed that the majority of these were small defects (<5 mm), none of which needed surgery. Roughly 85% of these closed by 1 year and the rest closed by 2 years of age. Of the ASDs more than 5 mm in size, around half of them closed spontaneously by 2 years of age and the other half needed surgery. This study helps to inform clinicians during consultations with parents and in deciding in regards to the frequency of follow ups.