Hostname: page-component-848d4c4894-ndmmz Total loading time: 0 Render date: 2024-05-29T07:15:37.464Z Has data issue: false hasContentIssue false
  • English
  • Français

Adverse events within 1 year after surgical and percutaneous closure of atrial septal defects in preterm children

Published online by Cambridge University Press:  04 June 2019

Gustaf Tanghöj Open the ORCID record for Gustaf Tanghöj [Opens in a new window] ,
Petru Liuba ,
Gunnar Sjöberg ,
Annika Rydberg  and
Estelle Naumburg
Gustaf Tanghöj*
Affiliation:
Department of Clinical Sciences, Unit of Paediatrics, Umeå University, Umeå, Sweden
Petru Liuba
Affiliation:
Department of Cardiology, Paediatric Heart Centre, Skåne University Hospital Lund, Lund, Sweden
Gunnar Sjöberg
Affiliation:
Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
Annika Rydberg
Affiliation:
Department of Clinical Sciences, Unit of Paediatrics, Umeå University, Umeå, Sweden
Estelle Naumburg
Affiliation:
Department of Clinical Sciences, Unit of Paediatrics, Umeå University, Umeå, Sweden
*
Author for correspondence: Gustaf Tanghöj, PhD student, Barnkliniken Östersunds Sjukhus, 831 82 Östersund, Sweden. Tel: +46 (0)63 153000; E-mail: gustaf.tanghoj@regionjh.se
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Atrial septal defect is the third most common CHD. A hemodynamically significant atrial septal defect causes volume overload of the right side of the heart. Preterm children may suffer from both pulmonary and cardiac comorbidities, including altered myocardial function. The aim of this study was to compare the rate of adverse events following atrial septal defect closure in preterm- and term-born children.

Method:

We performed a retrospective cohort study including children born in Sweden, who had a surgical or percutaneous atrial septal defect closure at the children’s hospitals in Lund and Stockholm, between 2000 and 2014, assessing time to the first event within 1 month or 1 year. We analysed differences in the number of and the time to events between the preterm and term cohort using the Kaplan–Meier survival curve, a generalised model applying zero-inflated Poisson distribution and Gary-Anderson’s method.

Results:

Overall, 413 children were included in the study. Of these, 93 (22.5%) were born prematurely. The total number of adverse events was 178 (110 minor and 68 major). There was no difference between the cohorts in the number of events, whether within 1 month or within a year, between major (p = 0.69) and minor (p = 0.84) events or frequencies of multiple events (p = 0.92).

Conclusion:

Despite earlier procedural age, larger atrial septal defects, and higher comorbidity than term children, preterm children appear to have comparable risk for complications during the first year after surgical or percutaneous closure.

Keywords

Childatrial septal defectpercutaneous closuresurgical closurecomplications
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 5 , May 2019 , pp. 626 - 636
Copyright
© Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Hoffman, JI, Kaplan, S, Liberthson, RR. The incidence of congenital heart disease. JACC 2002; 39: 1890–1900.CrossRefGoogle ScholarPubMed
Sugimoto, M, Kuwata, S, Kurishima, C, et al. Cardiac biomarkers in children with congenital heart disease. World J Pediatr 2015; 11: 309–315.CrossRefGoogle ScholarPubMed
Campbell, M. Natural history of atrial septal defect. Br Heart J 1970; 32: 820–826.CrossRefGoogle ScholarPubMed
Hoffman, JI, Rudolph, AM, Heymann, MA. Pulmonary vascular disease with congenital heart lesions: pathologic features and causes. Circulation 1981; 64: 873–877.CrossRefGoogle ScholarPubMed
Morken, NH, Kallen, K, Hagberg, H, Jacobsson, B. Preterm birth in Sweden 1973-2001: rate, subgroups, and effect of changing patterns in multiple births, maternal age, and smoking. Acta Obstet et Gynecol Scand 2005; 84: 558–565.CrossRefGoogle ScholarPubMed
Fellman, V, Hellstrom-Westas, L, Norman, M, et al. One-year survival of extremely preterm infants after active perinatal care in Sweden. JAMA 2009; 301: 2225–2233.Google ScholarPubMed
Tanner, K, Sabrine, N, Wren, C. Cardiovascular malformations among preterm infants. Pediatrics. 2005; 116: 833–838.CrossRefGoogle ScholarPubMed
Polito, A, Piga, S, Cogo, PE, et al. Increased morbidity and mortality in very preterm/VLBW infants with congenital heart disease. Intensive Care Med 2013; 39: 1104–1112.CrossRefGoogle ScholarPubMed
Tanghöj, G, Naumburg, E, Liuba, P. Early complications after percutaneous closure of atrial septal defect in infants with procedural weight less than 15 kg. Pediatr Cardiol 2017; 38: 255–263.CrossRefGoogle ScholarPubMed
Lee, YS, Jeng, MJ, Tsao, PC, et al. Pulmonary function changes in children after transcatheter closure of atrial septal defect. Pediatr Pulmonol 2009; 44: 1025–1032.CrossRefGoogle ScholarPubMed
Zaqout, M, De Baets, F, Schelstraete, P, et al. Pulmonary function in children after surgical and percutaneous closure of atrial septal defect. Pediatr Cardiol 2010; 31: 1171–1175.CrossRefGoogle ScholarPubMed
Bensley, JG, Stacy, VK, De Matteo, R, et al. Cardiac remodelling as a result of pre-term birth: implications for future cardiovascular disease. Eur Heart J 2010; 31: 2058–2066.CrossRefGoogle ScholarPubMed
Broadhouse, KM, Finnemore, AE, Price, AN, et al. Cardiovascular magnetic resonance of cardiac function and myocardial mass in preterm infants: a preliminary study of the impact of patent ductus arteriosus. J Cardiovasc Magn Reson 2014; 16: 54.CrossRefGoogle ScholarPubMed
Schubert, U, Muller, M, Abdul-Khaliq, H, et al. Preterm birth is associated with altered myocardial function in infancy. J Am Soc Echocardiogr 2016; 29: 670–678.CrossRefGoogle ScholarPubMed
Lewandowski, AJ, Augustine, D, Lamata, P, et al. Preterm heart in adult life: cardiovascular magnetic resonance reveals distinct differences in left ventricular mass, geometry, and function. Circulation 2013; 127: 197–206.CrossRefGoogle ScholarPubMed
Levy, PT, Dioneda, B, Holland, MR, et al. Right ventricular function in preterm and term neonates: reference values for right ventricle areas and fractional area of change. J Am Soc Echocardiogr 2015; 28: 559–569.CrossRefGoogle ScholarPubMed
Lewandowski, AJ, Bradlow, WM, Augustine, D, et al. Right ventricular systolic dysfunction in young adults born preterm. Circulation 2013; 128: 713–720.CrossRefGoogle ScholarPubMed
Mohlkert, LA, Hallberg, J, Broberg, O, et al. The preterm heart in childhood: left ventricular structure, geometry, and function assessed by echocardiography in 6-year-old survivors of periviable births. J Am Heart Assoc 2018; 7(2): pii: e007742.CrossRefGoogle ScholarPubMed
Feltes, TF, Bacha, E, Beekman, RH, et al. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation 2011; 123: 2607–2652.CrossRefGoogle ScholarPubMed
Du, Z-D, Hijazi, ZM, Kleinman, CS, et al. Comparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults. JACC 2002; 39: 1836–1844.CrossRefGoogle ScholarPubMed
Thilén, U, Jeremiasen, I, Björkhem, G, et al. Nationellt register för medfödda hjärtsjukdomar, 2016. Retrieved December 31st, 2016, from http://www.ucr.uu.se/swedcon/ Google Scholar
Karin Gottvall, EL, Källén, K. Graviditeter, förlossningar och nyfödda barn Medicinska födelseregistret 1973-2014 Assisterad befruktning, 1991–2013, Vol. 1. Socialstyrelsen, Stockholm, 2015: 95.Google Scholar
Bartakian, S, Fagan, TE, Schaffer, MS, et al. Device closure of secundum atrial septal defects in children <15 kg: complication rates and indications for referral. JACC Cardiovasc Interv 2012; 5: 1178–1184.CrossRefGoogle Scholar
Butera, G, Carminati, M, Chessa, M, et al. Percutaneous versus surgical closure of secundum atrial septal defect: comparison of early results and complications. Am Heart J 2006; 151: 228–234.CrossRefGoogle ScholarPubMed
Sadiq, M, Kazmi, T, Rehman, AU, et al. Device closure of atrial septal defect: medium-term outcome with special reference to complications. Cardiol Young 2012; 22: 71–78.CrossRefGoogle ScholarPubMed
Moore, J, Hegde, S, El-Said, H, et al. Transcatheter device closure of atrial septal defects: a safety review. JACC Cardiovasc Interv 2013; 6: 433–442.CrossRefGoogle ScholarPubMed
Shimpo, H, Hojo, R, Ryo, M, et al. Transcatheter closure of secundum atrial septal defect. Gen Thorac Cardiovasc Surg, 2017; 61: 614–618.CrossRefGoogle Scholar
Wyss, Y, Quandt, D, Weber, R, et al. Interventional closure of secundum type atrial septal defects in infants less than 10 kilograms: indications and procedural outcome. J Interv Cardiol 2016; 29: 646–653.CrossRefGoogle ScholarPubMed
Bishnoi, RN, Everett, AD, Ringel, RE, et al. Device closure of secundum atrial septal defects in infants weighing less than 8 kg. Pediatr Cardiol 2014; 35: 1124–1131.CrossRefGoogle ScholarPubMed
Wood, AM, Holzer, RJ, Texter, KM, et al. Transcatheter elimination of left-to-right shunts in infants with bronchopulmonary dysplasia is feasible and safe. Congenit Heart Dis 2011; 6: 330–337.CrossRefGoogle ScholarPubMed
Nykanen, DG, Forbes, TJ, Du, W, et al. CRISP: catheterization RISk score for pediatrics: a report from the Congenital Cardiac Interventional Study Consortium (CCISC). Catheter Cardiovasc Interv 2016; 87: 302–309.CrossRefGoogle Scholar
Collins, A, Weitkamp, JH, Wynn, JL. Why are preterm newborns at increased risk of infection? Arch Dis Child Fetal Neonatal Ed 2018; 103: 391–394.CrossRefGoogle ScholarPubMed
Cuypers, JA, Opic, P, Menting, ME, et al. The unnatural history of an atrial septal defect: longitudinal 35 year follow up after surgical closure at young age. Heart 2013; 99: 1346–1352.CrossRefGoogle ScholarPubMed
Bassareo, PP, Fanos, V, Puddu, M, et al. Significant QT interval prolongation and long QT in young adult ex-preterm newborns with extremely low birth weight. J Mater Fetal Neonatal Med 2011; 24: 1115–1118.CrossRefGoogle ScholarPubMed
Lee, C, Lim, G, Kim, WS, et al. Clinical characteristics and outcome of incidental atrial septal openings in very low birth weight infants. Neonatology 2014; 105: 85–90.CrossRefGoogle ScholarPubMed
Hanslik, A, Pospisil, U, Salzer-Muhar, U, et al. Predictors of spontaneous closure of isolated secundum atrial septal defect in children: a longitudinal study. Pediatrics 2006; 118: 1560–1565.CrossRefGoogle ScholarPubMed
Riggs, T, Sharp, SE, Batton, D, et al. Spontaneous closure of atrial septal defects in premature vs. full-term neonates. Pediatr Cardiol 2000; 21: 129–134.CrossRefGoogle ScholarPubMed
Beck, S, Wojdyla, D, Say, LV The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ 2010; 88: 31–38.CrossRefGoogle ScholarPubMed
Geva, T, Martins, JD, Wald, RM. Atrial septal defects. Lancet 2014; 383: 1921–1932.CrossRefGoogle ScholarPubMed
Joshi, S, Wilson, DG, Kotecha, S, et al. Cardiovascular function in children who had chronic lung disease of prematurity. Arch Dis Child Fetal Neonatal Ed 2014; 99: 373–379 CrossRefGoogle ScholarPubMed
Jobe, AH, Bancalari, E. Bronchopulmonary dysplasia. Am J Resp Crit Care Med 2001; 163: 1723–1729.CrossRefGoogle ScholarPubMed
Koestenberger, M, Nagel, B, Ravekes, W, et al. Systolic right ventricular function in preterm and term neonates: reference values of the tricuspid annular plane systolic excursion (TAPSE) in 258 patients and calculation of Z-score values. Neonatology 2011; 100: 85–92.CrossRefGoogle ScholarPubMed
Cnattingius, S, Ericson, A, Gunnarskog, J, Kallen, B. A quality study of a medical birth registry. Scand J Soc Med. 1990; 18: 143–148.CrossRefGoogle ScholarPubMed
Bordell, A, Bjorkhem, G, Thilén, U, et al. National quality register of congenital heart diseases - can we trust the data? J Congenit Cardiol 2017; 1: 11.CrossRefGoogle Scholar