LONG-TERM FOLLOW-UP OF CHILDREN AFTER REPAIR OF ATRIAL SEPTAL-DEFECTS

BACKGROUND It is critical to repair atrial septal defects during child hood to minimize long-term morbidity and mortality. However, only a fe w studies have examined factors that predict a favorable outcome. OBJE CTIVE To examine prognostic variables in the repair of atrial septal d efects. METHODS Retrospective analysis of children who underwent repai r of atrial septal defects between 1957 and 1981. RESULTS There were 7 0 girls and 57 boys with a mean age of 9.3 years at the time of surger y (range 4 months to 20 years). The most common presenting symptoms we re fatigue and dyspnea. Before surgery, 74% were in New York Heart Ass ociation functional class I, 70% had echocardiographic evidence of rig ht ventricular hypertrophy, and 55% had cardiomegaly on chest radiogra phs. The average mean pulmonary arterial pressure was 17.1 mm Hg. The only factor significantly related to poor outcome was pulmonary hypert ension. Age at surgery did not influence long-term results. Ninety-fou r percent of patients were in functional class I at follow-up. CONCLUS IONS Repair of atrial septal defects is safe before age 21, but it sho uld be done as early as possible in order to minimize the long-term co mplications of chronic left-to-right shunting.