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Abstract

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.