Title

The Effect on Somatic Growth of Surgical and Catheter Treatment of Secundum Atrial Septal Defects.

Document Type

Article

Publication Date

10-2017

Identifier

DOI: 10.1007/s00246-017-1678-6

Abstract

Historical studies suggest an association between atrial septal defect (ASD) and impaired growth with inconsistent improvement following closure. Limited data exist regarding the impact on growth in the era of transcatheter therapy. To evaluate the effect of closure on growth, we conducted a retrospective review of patients undergoing surgical or transcatheter closure during two time periods. Four hundred patients with isolated secundum ASD were divided into three cohorts: early surgical, contemporary surgical, and transcatheter. Data collected included demographics; height, weight, and body mass index (BMI) percentiles; catheterization hemodynamics; and co-morbidities. For all cohorts, there was no significant change in height or weight percentiles during two years after ASD closure. Age at repair was later for contemporary surgical and transcatheter cohorts (p < 0.0001). In the transcatheter cohort, mean Qp:Qs was 1.65 ± 0.54, but there was no correlation between greater Qp:Qs and decreased somatic growth. Subgroup analysis for patients with any initial growth percentile <5th percentile demonstrated a significant change in weight and BMI percentiles in the first two years after closure (p < 0.0004). The advent of transcatheter therapy shifted institutional practice to later age at repair for both surgical and transcatheter closure. There was no significant change in weight and height percentiles during two years after closure. Only patients with initial weight and BMI <5th percentile had improved growth after treatment. Concern for impaired growth should not generally be an indication for early ASD repair. However, early repair may be indicated in children with existing significant growth failure.

Journal Title

Pediatric cardiology

Volume

38

Issue

7

First Page

1410

Last Page

1414

MeSH Keywords

Adolescent; Anthropometry; Cardiac Catheterization; Child; Child Development; Child, Preschool; Cohort Studies; Female; Growth Disorders; Heart Septal Defects, Atrial; Hemodynamics; Humans; Infant; Male; Retrospective Studies; Septal Occluder Device; Treatment Outcome

Keywords

Atrial septal defect; Children; Congenital heart disease; Growth; Intervention

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