Outcome of Surgical Closure of Atrial Septal Defect in Sulaimani City

  • Aso Faeq Salih ORCID Mail Department of Pediatrics, College of Medicine, University of Sulaimani, Al-Sulaymaniyah, Iraq.
  • Hakam Marwan Mhadi Sulaimani Pediatric Teaching Hospital, Al-Sulaymaniyah, Iraq.
  • Shkar Raeof Department of Surgery, College of Medicine, University of Sulaimani, Al-Sulaymaniyah, Iraq
Keywords:
Atrial septal defect, Surgery, Children

Abstract

An atrial septal defect (ASD), sometimes called a hole in the heart is a type of congenital heart defect in which there is an abnormal opening in the dividing wall between the upper filling chambers of the heart (the atria). To determine the outcome of surgical closure in patients with atrial septal defects, we designed a retrospective study, including 120 patients present with an atrial septal defect after surgical closure done in the cardiac teaching center in Sulaimani city. The data collected include the patients that admitted which are known cases of ASD and treated by open heart surgery during the last nine years from 1st of January 2008 until the 1st of January 2018. A total of 120 children diagnosed with Atrial Septal Defect (ASD) were included in this study with a mean age of 7.8±4.4 years; 32.5% of them were 1-5 years old, 50.8% of them were in the age group 6-12 years, and 16.7% of them were in the age group 13-19 years. Only three ASD children received medical treatment while all of them were treated surgically with open-heart surgery. The mean age of ASD children at surgery was7.8±4.4 years; 5.8% of them were 1-2 years old, 28.4% of them were 3-5 years old, 49.1% of them were in the age group 6-12 years, and 16.7% of them were in the age group 13-19 years. There was a significant association between primum ASD type and large ASD with posteroinferior deficient rims (P=0.04). A significant association was observed between primum ASD type and large IAS (P=0.006). Mean ASD diameter was significantly higher among patients with primum ASD type (P=0.01). The outcome of surgical closure of the atrial septal defect in children is effective and safe. Ventricular arrhythmia in the form of ectopic was the postoperative complication in one patient. The main echocardiography findings of children with atrial septal defects were large ASD with posteroinferior deficient rims.

References

1. CONSTANTINESCU T, MAGDA SL, NICULESCU R, MINCU RI, ZAHARIA D, TOMA CL, et al. New echocardiographic tehniques in pulmonary arterial hypertension vs. right heart catheterization–a pilot study. Maedica. 2013;8(2):116.
2. Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American college of cardiology/American heart association task force on practice guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease) developed in collaboration with the american society of echocardiography, heart rhythm society, international society for adult congenital heart disease, society for cardiovascular angiography and interventions, and society of thoracic surgeons. Journal of the American College of Cardiology. 2008;52(23):e143-e263.
3. Marelli AJ, Mackie AS, Ionescu-Ittu R, Rahme E, Pilote L. Congenital heart disease in the general population: changing prevalence and age distribution. Circulation. 2007;115(2):163-72.
4. Ostermayer SH, Srivastava S, Doucette JT, Ko HH, Geiger M, Parness IA, et al. Malattached septum primum and deficient septal rim predict unsuccessful transcatheter closure of atrial communications. Catheterization and Cardiovascular Interventions. 2015;86(7):1195-203.
5. Ak K, Aybek T, Wimmer-Greinecker G, Özaslan F, Bakhtiary F, Moritz A, et al. Evolution of surgical techniques for atrial septal defect repair in adults: a 10-year single-institution experience. The Journal of thoracic and cardiovascular surgery. 2007;134(3):757-64.
6. Poyrazoglu HH, Avsar MK, Demir Ş, Karakaya Z, Güler T, Tor F. Atrial septal defect closure: comparison of vertical axillary minithoracotomy and median sternotomy. The Korean journal of thoracic and cardiovascular surgery. 2013;46(5):340.
7. Johnson JN, Marquardt ML, Ackerman MJ, Asirvatham SJ, Reeder GS, Cabalka AK, et al. Electrocardiographic changes and arrhythmias following percutaneous atrial septal defect and patent foramen ovale device closure. Catheterization and Cardiovascular Interventions. 2011;78(2):254-61.
8. Quek SC, Hota S, Tai BC, Mujumdar S, Tok MY. Comparison of clinical outcomes and cost between surgical and transcatheter device closure of atrial septal defects in Singapore children. Annals Academy of Medicine Singapore. 2010;39(8):629.
9. GALAL MO, WOBST A, HALEES Z, HATLE L, SCHMALTZ AA, KHOUGEER F, et al. Peri-operative complications following surgical closure of atrial septal defect type II in 232 patients—a baseline study. European Heart Journal. 1994;15(10):1381-4.
10. Putra ST, Djer MM, Idris NS, Samion H, Sastroasmoro S. Transcatheter closure of atrial septal defects in a center with limited resources: outcomes and short term follow-up. Iranian journal of pediatrics. 2015;25(6).
11. Kamal N, Othman N, Salih A. Incidence and types of congenital heart diseases among children in Sulaimani Governorate. Kurdistan Journal of Applied Research. 2017;2(2):106-11.
12. Kim HR, Jung S-H, Park JJ, Yun TJ, Choo SJ, Chung CH, et al. Risk analysis of the long-term outcomes of the surgical closure of secundum atrial septal defects. The Korean journal of thoracic and cardiovascular surgery. 2017;50(2):78.
13. Bialkowski J, Karwot B, Szkutnik M, Banaszak P, Kusa J, Skalski J. Closure of atrial septal defects in children: Surgery versus Amplatzer® device implantation. Texas Heart Institute Journal. 2004;31(3):220.
14. Spence MS, Qureshi SA. Complications of transcatheter closure of atrial septal defects. BMJ Publishing Group Ltd; 2005.
15. Baskett R, Tancock E, Ross D. The gold standard for atrial septal defect closure. Pediatric cardiology. 2003;24(5):444-7.
16. Hopkins RA, Bert AA, Buchholz B, Guarino K, Meyers M. Surgical patch closure of atrial septal defects. The Annals of thoracic surgery. 2004;77(6):2144-9.
17. Ruiz-Perez VL, Ide SE, Strom TM, Lorenz B, Wilson D, Woods K, et al. Mutations in a new gene in Ellis-van Creveld syndrome and Weyers acrodental dysostosis. Nature genetics. 2000;24(3):283.
18. Dodge-Khatami A, Miller OI, Anderson RH, Goldman AP, Gil-Jaurena JM, Elliott MJ, et al. Surgical substrates of postoperative junctional ectopic tachycardia in congenital heart defects. The Journal of thoracic and cardiovascular surgery. 2002;123(4):624-30.
19. Khairy P, Balaji S. Cardiac arrhythmias in congenital heart diseases. Indian pacing and electrophysiology journal. 2009;9(6):299.
20. Wu H-C, Wang C-C, Fu Y-C, Jan S-L, Wei H-J, Lin Y-K, et al. Surgical management for complications during closure of atrial septal defect with Amplatzer device. Acta Cardiologica Sinica. 2013;29(6):557.
21. Çeliker A, Ozkutlu S, Karakurt C, Karagoz T. Cardiac dysrhythmias after transcatheter closure of ASD with Amplatzer device. Turkish Journal of Pediatrics. 2005;47(4):323.
22. Fawzi MM KH, Tawfeeq WF. Patterns of Congenital Heart Diseases among Children in Mosul city. Third Scientific Conference of Laparoscopic Surgery-College of Medicine-Mosul University mosul2013. p. 96-102.
23. Geva T, Martins JD, Wald RM. Atrial septal defects. The Lancet. 2014;383(9932):1921-32.
24. Andrews R, Tulloh R, Magee A, Anderson D. Atrial septal defect with failure to thrive in infancy: hidden pulmonary vascular disease? Pediatric cardiology. 2002;23(5):528-30.
25. Parvathy U, Balakrishnan KR, Ranjith MS, Saldanha R, Vakamudi M. Surgical closure of atrial septal defect in children under two years of age. Asian Cardiovascular and Thoracic Annals. 2004;12(4):296-9.
26. Behjati-Ardakani M, Golshan M, Akhavan-Karbasi S, Hosseini S-M, Behjati-Ardakani M-A, Sarebanhassanabadi M. The clinical course of patients with atrial septal defects. Iranian journal of pediatrics. 2016;26(4).
27. Langlois PH, Scheuerle A, Horel SA, Carozza SE. Urban versus rural residence and occurrence of septal heart defects in Texas. Birth Defects Research Part A: Clinical and Molecular Teratology. 2009;85(9):764-72.
28. J. S. Atrial Septal Defect Effects, Electrocardiographic Signs and Shunt Volume. Current Pediatric Research. 2016;20(1 and 2):209-.
29. AI-Quraishi MH, Alhammash SM, Abdullah HA-WM, Victor I, Kuraidi AK. nonsurgical closure of secundum atrial septal defect by percutaneous transcatheter amplatzer septal occluder. Journal of the Faculty of Medicine. 2008;50(1):20-30.
30. Song J. Comprehensive understanding of atrial septal defects by imaging studies for successful transcatheter closure. Korean journal of pediatrics. 2014;57(7):297.
31. El-Said HG, Bezold LI, Grifka RG, Pignatelli RH, McMahon CJ, Schutte DA, et al. Sizing of atrial septal defects to predict successful closure with transcatheter CardioSEAL™ device. Texas Heart Institute Journal. 2001;28(3):177.
32. Rao PS, Harris AD. Recent advances in managing septal defects: atrial septal defects. F1000Research. 2017;6.
33. Sayasathid J, Sukonpan K, Somboonna N. Epidemiology and etiology of congenital heart diseases. Congenital Heart Disease-Selected Aspects: IntechOpen; 2012.
34. Silvestry FE, Cohen MS, Armsby LB, Burkule NJ, Fleishman CE, Hijazi ZM, et al. Guidelines for the echocardiographic assessment of atrial septal defect and patent foramen ovale: from the American Society of Echocardiography and Society for Cardiac Angiography and Interventions. Journal of the American Society of Echocardiography. 2015;28(8):910-58.
35. Funjan MM. A STUDY OF LEFT ATRIAL APPENDAGE FLOW BY DOPPLERTRANSESOPHAGEAL ECHOCARDIOGRAPHY IN PATIENTS WITHATRIAL SEPTAL DEFECT. Al-Nahrain Journal of Science. 2009;12(1):52-60.
36. Al-Ani ZR. Association of consanguinity with congenital heart diseases in a teaching hospital in Western Iraq. Saudi Med J. 2010;31(9):1021-7.
Published
2020-08-10
How to Cite
1.
Salih A, Mhadi H, Raeof S. Outcome of Surgical Closure of Atrial Septal Defect in Sulaimani City. Acta Med Iran. 58(5):225-233.
Section
Articles