Atrial septal defects that present in infancy
L. T. Mahoney, S. C. Truesdell, T. R. Krzmarzick and R. M. Lauer
The diagnosis of isolated secundum atrial septal defect (ASD) in infancy is
uncommon. We studied 26 infants with ASD confirmed at cardiac
catheterization. Of these, nine were born prematurely, 15 presented with
symptoms of congestive heart failure, and only three were noted to have the
clinical features of an ASD in spite of large left to right shunts. All but
two patients responded to medical management. Spontaneous closure of the
ASD was documented in 39% (ten) of the patients at ages ranging from 2 to 8
years. Twelve patients underwent surgical closure at a mean age of 4 years.
No variables at presentation were predictive of subsequent spontaneous
closure. In view of the high rate of spontaneous closure and the success of
medical therapy, most infants with symptomatic ASD may be managed
medically, allowing sufficient time to observe whether spontaneous closure
will occur.
