Adverse events within 1 year after surgical and percutaneous closure of atrial septal defects in preterm children

Tanghöj, Gustaf; Liuba, Petru; Sjöberg, Gunnar; Rydberg, Annika; Naumburg, Estelle

doi:10.1017/s1047951119000350

Cited by 8 publications

(4 citation statements)

References 43 publications

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“…The incidence of postoperative complications in symptomatic patients in our study was low [19] and comparable with reports in older asymptomatic patients [18,21,22]. Tanghoj et al studied risk factors for adverse events following transcatheter and surgical ASD closure in children born preterm and concluded that prematurity was not a risk factor for post-procedural complications despite earlier procedural age, larger ASD size, and higher comorbidity than term infants [23,24].…”

Section: Hemodynamic Improvement Granted By Asd Closuresupporting

confidence: 85%

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Tsuda¹,

Bhat²

2021

Journal of Clinical Cardiology

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Infants and children with isolated atrial septal defect (ASD) usually do not develop clinical signs or symptoms. However, infants with premature birth complicated by chronic lung disease may develop certain problems including respiratory distress, dependency upon supplemental oxygen and/or mechanical ventilation, failure to thrive, and prolonged hospitalization; these are induced largely by excessive pulmonary blood flow through ASD. Although transcatheter approach is less invasive than surgery, its feasibility is often limited by anatomical conditions of ASD and the size of the patients. In these circumstances, surgical closure can be performed safely and effectively even in sick infants to improve clinical status. When transcatheter approach is not feasible, the surgical closure of ASD results in a favorable outcome by eliminating excessive pulmonary blood flow, mitigating the need of positive pressure ventilation more quickly, and promoting better physical growth.

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Section: Hemodynamic Improvement Granted By Asd Closuresupporting

confidence: 85%

Untitled

Tsuda¹,

Bhat²

2021

Journal of Clinical Cardiology

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“…Adverse events were categorised according to severity and were presented in detail in a previous publication. 20 The risk factor "Symptomatic atrial septal defects" was used when stated in the medical journal as diagnoses related to heart failure according to International classification of disease (ICD 10 I50.0-9) and/or if the child was treated with antidiuretic drugs. 21,22 The risk factor "pulmonary hypertension" was used when echocardiographic findings indicated a systolic right ventricular pressure ≥25 mmHg, by measures of the tricuspid regurgitant velocity > 2.6 m/second, or when invasive catheter measurements showed a mean pulmonary artery pressure of ≥25 mmHg pulmonary or a pulmonary vascular resistance of ≥3 WU × m 2 , all prior to the atrial septal defect closure.…”

Section: Methodsmentioning

confidence: 99%

Risk factors for adverse events within one year after atrial septal closure in children: a retrospective follow-up study

et al. 2019

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Introduction:Secundum atrial septal defect is one of the most common congenital heart defects. Previous paediatric studies have mainly addressed echocardiographic and few clinical factors among children associated with adverse events. The aim of this study was to identify neonatal and other clinical risk factors associated with adverse events up to one year after closure of atrial septal defect.Methods:This retrospective case–control study includes children born in Sweden between 2000 and 2014 that were treated surgically or percutaneously for an atrial septal defect. Conditional logistic regression was used to evaluate the association between major and minor adverse events and potential risk factors, adjusting for confounding factors including prematurity, neonatal sepsis, neonatal general ventilatory support, symptomatic atrial septal defects, and pulmonary hypertension.Results:Overall, 396 children with 400 atrial septal defect closures were included. The median body weight at closure was 14.5 (3.5–110) kg, and the median age was 3.0 (0.1–17.8) years. Overall, 110 minor adverse events and 68 major events were recorded in 87 and 49 children, respectively. Only symptomatic atrial septal defects were associated with both minor (odds ratio (OR) = 2.18, confidence interval (CI) 95% 1.05–8.06) and major (OR = 2.80 CI 95% 1.23–6.37) adverse events.Conclusion:There was no association between the investigated neonatal comorbidities and major or minor events after atrial septal defect closure. Patients with symptomatic atrial septal defects had a two to four times increased risk of having a major event, suggesting careful management and follow-up of these children prior to and after closure.

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“…In our study, the risk of an early ASD closure was associated with estimated ASD size:bodyweight ratio of 0.8 and of 2.0, even after adjustments for potential confounders. In a previous study, we did not find an increased risk of adverse events following ASD closure for children with large or small ASD size:bodyweight ratios (13). This indicates that the ASD size:bodyweight ratio cannot be the only predictor of the need for an early closure nor for the risk of adverse events.…”

Section: Asd Size:bodyweight Ratiomentioning

confidence: 60%

“…The study included all children born in Sweden who were treated with an ASD closure, surgically or percutaneously, before the age of 18, between January 2000 and December 2014 at Skåne University Hospital in Lund and the Astrid Lindgren Children's Hospital at Karolinska University Hospital in Stockholm, Sweden. This cohort was studied in a previous study on adverse events after ASD closure (13). Cases were children aged 2 years or younger at the time of ASD closure.…”

Section: Methodsmentioning

confidence: 99%

Predictors of the Need for an Atrial Septal Defect Closure at Very Young Age

Tanghöj

Liuba

Sjöberg

et al. 2020

Front. Cardiovasc. Med.

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An asymptomatic Atrial Septal Defect (ASD) is often closed at the age of 3-5 years using a transcatheter or surgical technique. Symptomatic ASD or ASD associated with pulmonary hypertension (PHT) may require earlier closure, particularly in combination with other non-cardiac risk factors for PHT, but the indications for early closure and the potential risk for complications are largely unknown. The aim of this study was to assess risk factors for needing ASD closure during the first and second years of life. This case-control study included all children treated with surgical or percutaneous ASD closure between 2000 and 2014 at two out of three pediatric heart centers in Sweden. "Cases" were children with ASD closure at ≤1 or ≤2 years of age. Clinical data were retrieved from medical journals and national registries. Overall, 413 children were included. Of these, 131 (32%) were ≤2 years, and 50 (12%) were ≤1 year. Risk factors associated with a ≤2 years ASD closure were preterm birth, OR = 2.4 (95% CI: 1.5-3.9); additional chromosomal abnormalities, OR = 3.4 (95% CI: 1.8-6.5); pulmonary hypertension, OR = 5.8 (95% CI: 2.6-12.6); and additional congenital heart defects, OR = 2.6 (95% CI: 1.7-4.1). These risk associations remained after adjustments for confounding factors, such as need for neonatal respiratory support, neonatal pulmonary diseases, neonatal sepsis, additional congenital heart defects (CHD) and chromosomal abnormalities. ASD size:body weight ratio of 2.0, as well as a ratio of 0.8 (upper and lower limit of the ASD size:body weight ratios), was associated with increased risk of an early ASD closure. Risk factors such as very premature birth, very low birth weight, congenital, and chromosomal abnormalities, neonatal pulmonary disease and need for ventilation support, as well as pulmonary hypertension, were associated with very early (<1 year of age) ASD closure. Several independent neonatal risk factors were associated with an increased risk of early ASD closure at 2 and at 1 year of age. An ASD size:body weight ratio is a poor predictor for indications for ASD closure.

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Adverse events within 1 year after surgical and percutaneous closure of atrial septal defects in preterm children

Cited by 8 publications

References 43 publications

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Risk factors for adverse events within one year after atrial septal closure in children: a retrospective follow-up study

Predictors of the Need for an Atrial Septal Defect Closure at Very Young Age

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