Serial hemodynamic observations in secundum atrial septal defect with special reference to spontaneous closure

Abstract

Forty patients with atrial septal defect of secundum type diagnosed by cardiac catheterization underwent repeat study 1 ½ to 14 years later to document the frequency of spontaneous closure. These 40 patients were classified in two groups of 20 each according to age. Group 1 comprised 20 patients who were less than 1 year of age on the initial study and Group 2 comprised 20 patients who were older than 1 year on the initial study. Eleven of the 20 patients in Group 1 were noted to have spontaneous closure of the atrial septal defect on repeat study. The incidence of spontaneous closure was not necessarily related to the size of the defect. In contrast, none of the 20 patients in Group 2 had spontaneous closure on repeat study. Our data indicate that atrial septal defect of secundum type diagnosed in the first year of life frequently closes spontaneously. If the defect is diagnosed after the first year, it is unlikely to close spontaneously.