Dependence on a respiratory ventilator due to an atrial septal defect

Motz, Reinald; Grässl, Gerhard; Trawöger, Rudolf

doi:10.1017/s1047951100006636

Cited by 12 publications

(16 citation statements)

References 4 publications

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“…Of the 13 patients who underwent device closure in our series, 11 patients have improved clinically. The patients in our study with significant respiratory failure, dependency on oxygen, and poor weight gain demonstrated clinical improvement after device closure and subsequent elimination of the left to right shunt as has been previously reported 6,13 …”

Section: Discussionsupporting

confidence: 78%

“…Systemic to pulmonary shunting with resultant increased pulmonary blood flow may lead to the eventual loss of physiologic compensation resulting in edema and endothelial injury 12 . The accumulation of interstitial fluids is aggravated by excessive administration of fluids and increased flow in the lungs due to left to right shunting 13 . In the presence of a left to right shunt, increased pulmonary blood flow might further enhance the pulmonary vascular remodeling already induced by other factors and result in pulmonary vascular obstructive disease 10,14 .…”

Section: Discussionmentioning

confidence: 99%

“…Atrial shunting may also influence acute and chronic respiratory outcomes and may be an additional risk factor in the development of CLD 19 . CLD is a significant problem in the long term prognosis of premature infants and shunting across the ASD plays an important role in the development and persistence of dependency on respiratory support due to BPD 13 . In a child with significant lung disease, the added burden of a left to right shunt may worsen clinical status 6 …”

Section: Discussionmentioning

confidence: 99%

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Transcatheter Closure of Secundum Atrial Septal Defect in Infants Less than 12 Months of Age Improves Symptoms of Chronic Lung Disease

Thomas¹,

Vincent²,

Raviele³

et al. 2011

Congenital Heart Disease

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Transcatheter Closure of Secundum Atrial Septal Defect in Infants Less than 12 Months of Age Improves Symptoms of Chronic Lung Disease

Thomas¹,

Vincent²,

Raviele³

et al. 2011

Congenital Heart Disease

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“…Several case reports have found that ASOs significantly deteriorated pulmonary status [19,20]. In our study, none of the infants required intervention to close the ASO during follow-up.…”

Section: Discussionmentioning

confidence: 50%

Clinical Characteristics and Outcome of Incidental Atrial Septal Openings in Very Low Birth Weight Infants

Lee¹,

Lim²,

Kim³

et al. 2013

Neonatology

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Background: Atrial septal openings (ASOs) are very common in premature infants. Objective: The study aimed to evaluate the prevalence and natural course of ASOs in very low birth weight (VLBW) infants diagnosed in the first week of life and the association of ASOs with various clinical factors. Methods: We retrospectively reviewed the medical records of 217 infants born with a weight of <1,500 g between January 2007 and December 2011. Echocardiography was conducted within the first week of life in all infants. Clinical factors were compared between infants with ASO and those with an intact atrial septum. ASO closure was confirmed by echocardiography at the 3-month follow-up and subsequently every 6 months. Results: The incidence of ASOs was 40.3% in VLBW infants. Patent ductus arteriosus (PDA) was associated with a higher incidence of ASO in a multivariate analysis (OR 4.005, 95% CI 2.015-7.960, p < 0.001), and PDA was a predictor of early ASO closure. The rate of oxygen requirement for at least 28 days was higher in infants with ASO, whereas oxygen dependency at 36 weeks' postmenstrual age did not differ between the infant groups. The mean time of closure was 5.8 ± 7.1 months of age (range 0-36). All followed infants showed spontaneous closure within 3 years. Conclusions: ASOs occur at a relatively high incidence in VLBW infants, but most of these close spontaneously within 3 years. PDA was predictive of ASO at the first echocardiography but did not delay ASO closure. The ASOs in VLBW infants were not a significant cause of concern.

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“…[2-4] Surgical and catheter closure of such defects result in rapid respiratory improvement, with early extubation and oxygen weaning. [23] Unfortunately, this patient was referred at a later age to our center and the positive effects of early PDA ligation on the underlying respiratory status could not be assessed. It is likely that early PDA ligation in the neonatal period could have averted the chronic lung disease and the need for the procedure described herein.…”

Section: Discussionmentioning

confidence: 99%

Hybrid management of a large atrial septal defect and a patent ductus arteriosus in an infant with chronic lung disease

2010

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We report a case wherein a dysmorphic four-month-old infant (weighing 4.5 kgs) with an 8 mm atrial septal defect (ASD), a 1.5 mm patent ductus arteriosus (PDA), a 2 mm mid-muscular ventricular septal defect (VSD) associated with chronic lung disease, and severe pulmonary hypertension, was successfully managed using a hybrid approach, without the use of cardiopulmonary bypass (CPB). Through a median sternotomy, the PDA was ligated and the ASD was closed with a 9 mm Amplatzer septal occluder implanted through peratrial access. The VSD was left untouched. Serial echocardiograms showed complete closure of the ASD and PDA, with progressive normalization of the pulmonary artery (PA) pressures within three months. The child rapidly gained weight and was weaned from sildenafil and oxygen administration. After 12 months, the VSD closed spontaneously and the child remained well, with normal PA pressures. A hybrid approach without the use of CPB should be considered in the management of infants with congenital heart disease, associated with chronic lung disease and pulmonary hypertension.

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Dependence on a respiratory ventilator due to an atrial septal defect

Cited by 12 publications

References 4 publications

Transcatheter Closure of Secundum Atrial Septal Defect in Infants Less than 12 Months of Age Improves Symptoms of Chronic Lung Disease

Transcatheter Closure of Secundum Atrial Septal Defect in Infants Less than 12 Months of Age Improves Symptoms of Chronic Lung Disease

Clinical Characteristics and Outcome of Incidental Atrial Septal Openings in Very Low Birth Weight Infants

Hybrid management of a large atrial septal defect and a patent ductus arteriosus in an infant with chronic lung disease

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