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Early Onset of Pulmonary Vascular Obstruction With Atrial Septal Defect

Early Onset of Pulmonary Vascular Obstruction With Atrial Septal Defect Abstract TODAY the diagnosis of atrial septal defect (ASD) in childhood no longer engenders anxiety or even a sense of urgency. The repair of an uncomplicated ASD is associated with a low and quite generally acceptable mortality.1-4 That there is no aspect of urgency is attributable to a preponderant evidence that ASD is benign in childhood.5-10 Indeed, not only may there be a remarkable longevity associated with this lesion11-16 but the patients attaining such longevity commonly do not demonstrate significant pulmonary hypertension.12-16 This is not to say, however, that a certain morbidity and mortality has not been ascribed to ASD in infancy and childhood. Hastreiter et al10 described 13 cases in which congestive heart failure secondary to ASD was considered the primary cause of death. All of these patients developed a fulminant clinical picture prior to 18 months of age. Only three patients were older than References 1. McGoon, D.C.; DuShane, J.W.; and Kirklin, J.W.: Surgical Treatment of Atrial Septal Defect in Children , Pediatrics 24:992-995 ( (Dec) ) 1959. 2. Daicoff, G.R.; Brandenburg, R.O.; and Kirklin, J.W.: Results of Operation for Atrial Septal Defect in Patients Forty-five Years of Age and Older , Circulation 34 ( (suppl 1) ):143-147 (April) 1967. 3. Wolf, P.S., et al: Atrial Septal Defect in Patients Over Forty-five Years of Age: Merits of Surgical Versus Medical Therapy , Brit Heart J 30: 115-124 ( (Jan) ) 1968.Crossref 4. Gault, J.H., et al: Atrial Septal Defect in Patients Over the Age of Forty Years , Circulation 37: 261-272 ( (Feb) ) 1968.Crossref 5. Witham, A.C., and Ellison, R.G.: Diagnosis of Ostium Primum Defects of the Atrial Septum , Amer J Med 22:593-604 ( (April) ) 1957.Crossref 6. Keith, J.D.; Rowe, R.D.; and Vlad, P.: Heart Disease in Infancy and Childhood , New York: The Macmillan Co., 1958, p 262. 7. Fontana, R.S., and Edwards, J.E.: Congenital Cardiac Disease: A Review of 357 Cases Studied Pathologically , Philadelphia: W. B. Saunders Co., 1962, p 68. 8. Nadas, A.S.: Pediatric Cardiology , ed 2, Philadelphia: W. B. Saunders Co., 1963, pp 371-392. 9. Mark, H.: Natural History of Atrial Septal Defect With Criteria for Selection for Surgery , Amer J Cardiol 12:66-74 ( (July) ) 1963.Crossref 10. Hastreiter, A.R., et al: Secundum Atrial Septal Defects With Congestive Heart Failure During Infancy and Early Childhood , Amer Heart J 64:467-472 ( (Oct) ) 1962.Crossref 11. Ellis, F.R.; Greaves, M.; and Hecht, H.H.: Congenital Heart Disease in Old Age: Interauricular Septal Defect With Mitral and Tricuspid Valvulitis , Amer Heart J 40:154-161 ( (July) ) 1950.Crossref 12. Wood, P.H.: Diseases of the Heart and Circulation , ed 2, Philadelphia: J. B. Lippincott Co., 1956, p 318. 13. Kelly, J.J., and Lyons, H.H.: Atrial Septal Defect in the Aged , Ann Intern Med 48:267-282 ( (Feb) ) 1958.Crossref 14. Ellis, F.H., Jr.; Brandenburg, R.O.; and Swan, H.J.C.: Defect of the Atrial Septum in the Elderly , New Eng J Med 262:219-224 ( (Feb) ) 1960.Crossref 15. Rodstein, M.; Zeman, F.D.; and Gerber, I.E.: Atrial Septal Defect in the Aged , Circulation 23: 665-674 ( (May) ) 1961.Crossref 16. Adams, C.W.: A Reappraisal of Life Expectancy With Atrial Shunts of the Secundum Type , Dis Chest 48:357-376 ( (Oct) ) 1965.Crossref 17. Taussig, H.B.: Congenital Malformations of the Heart: II. Specific Malformations , ed 2, Cambridge, Mass: Harvard University Press, 1960, pp 613-620. 18. McGoon, D.C., et al: Atrial Septal Defect: Factors Affecting the Surgical Mortality Rate , Circulation 19:195-200 ( (Feb) ) 1959.Crossref 19. Blount, S.G., Jr.; Balchum, O.J.; and Gensini, G.: The Persistent Ostium Primum Atrial Septal Defect , Circulation 13:499-508 ( (April) ) 1956.Crossref 20. Evans, J.R.; Rowe, R.O.; and Keith, J.D.: The Clinical Diagnosis of Atrial Septal Defect in Children , Amer J Med 30:345-356 ( (March) ) 1961.Crossref 21. Coelho, E.; dePaira, E.; and Nunes, A.: Selective Angiocardiography in the Diagnosis of Atrial Septal Defect (Ostium Secundum Type) , Amer J Cardiol 7:167-175 ( (Feb) ) 1961.Crossref 22. Sheperd, J.T., et al: Clinical, Physiological and Pathological Considerations in Patients With Idiopathic Pulmonary Hypertension , Brit Heart J 19:70-82 ( (Jan) ) 1957.Crossref 23. Husson, G.S., and Wyatt, T.C.: Primary Pulmonary Obliterative Vascular Disease in Infants and Young Children , Pediatrics 23:493-506 ( (March) ) 1959. 24. Sleeper, J.C.; Orgain, E.S.; and McIntosh, H.D.: Primary Pulmonary Hypertension: Review of Clinical Features and Pathologic Physiology With a Report of Pulmonary Hemodynamics Derived From Repeated Catheterization , Circulation 26:1358-1369 ( (Dec) ) 1962.Crossref 25. Heath, D.; Whitaker, W.; and Brown, J.W.: Idiopathic Pulmonary Hypertension , Brit Heart J 19:83-92 ( (Jan) ) 1957.Crossref 26. Evans, W.; Short, D.S.; and Bedford, D.E.: Solitary Pulmonary Hypertension , Brit Heart J 19: 93-116 ( (Jan) ) 1957.Crossref 27. Kuida, H., et al: Primary Pulmonary Hypertension , Amer J Med 23:166-182 ( (Aug) ) 1957.Crossref 28. Fowler, N.O., et al: Idiopathic and Thromboembolic Pulmonary Hypertension , Amer J Med 40: 331-345 ( (March) ) 1966.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Early Onset of Pulmonary Vascular Obstruction With Atrial Septal Defect

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References (31)

Publisher
American Medical Association
Copyright
Copyright © 1969 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1969.02100030323013
Publisher site
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Abstract

Abstract TODAY the diagnosis of atrial septal defect (ASD) in childhood no longer engenders anxiety or even a sense of urgency. The repair of an uncomplicated ASD is associated with a low and quite generally acceptable mortality.1-4 That there is no aspect of urgency is attributable to a preponderant evidence that ASD is benign in childhood.5-10 Indeed, not only may there be a remarkable longevity associated with this lesion11-16 but the patients attaining such longevity commonly do not demonstrate significant pulmonary hypertension.12-16 This is not to say, however, that a certain morbidity and mortality has not been ascribed to ASD in infancy and childhood. Hastreiter et al10 described 13 cases in which congestive heart failure secondary to ASD was considered the primary cause of death. All of these patients developed a fulminant clinical picture prior to 18 months of age. Only three patients were older than References 1. McGoon, D.C.; DuShane, J.W.; and Kirklin, J.W.: Surgical Treatment of Atrial Septal Defect in Children , Pediatrics 24:992-995 ( (Dec) ) 1959. 2. Daicoff, G.R.; Brandenburg, R.O.; and Kirklin, J.W.: Results of Operation for Atrial Septal Defect in Patients Forty-five Years of Age and Older , Circulation 34 ( (suppl 1) ):143-147 (April) 1967. 3. Wolf, P.S., et al: Atrial Septal Defect in Patients Over Forty-five Years of Age: Merits of Surgical Versus Medical Therapy , Brit Heart J 30: 115-124 ( (Jan) ) 1968.Crossref 4. Gault, J.H., et al: Atrial Septal Defect in Patients Over the Age of Forty Years , Circulation 37: 261-272 ( (Feb) ) 1968.Crossref 5. Witham, A.C., and Ellison, R.G.: Diagnosis of Ostium Primum Defects of the Atrial Septum , Amer J Med 22:593-604 ( (April) ) 1957.Crossref 6. Keith, J.D.; Rowe, R.D.; and Vlad, P.: Heart Disease in Infancy and Childhood , New York: The Macmillan Co., 1958, p 262. 7. Fontana, R.S., and Edwards, J.E.: Congenital Cardiac Disease: A Review of 357 Cases Studied Pathologically , Philadelphia: W. B. Saunders Co., 1962, p 68. 8. Nadas, A.S.: Pediatric Cardiology , ed 2, Philadelphia: W. B. Saunders Co., 1963, pp 371-392. 9. Mark, H.: Natural History of Atrial Septal Defect With Criteria for Selection for Surgery , Amer J Cardiol 12:66-74 ( (July) ) 1963.Crossref 10. Hastreiter, A.R., et al: Secundum Atrial Septal Defects With Congestive Heart Failure During Infancy and Early Childhood , Amer Heart J 64:467-472 ( (Oct) ) 1962.Crossref 11. Ellis, F.R.; Greaves, M.; and Hecht, H.H.: Congenital Heart Disease in Old Age: Interauricular Septal Defect With Mitral and Tricuspid Valvulitis , Amer Heart J 40:154-161 ( (July) ) 1950.Crossref 12. Wood, P.H.: Diseases of the Heart and Circulation , ed 2, Philadelphia: J. B. Lippincott Co., 1956, p 318. 13. Kelly, J.J., and Lyons, H.H.: Atrial Septal Defect in the Aged , Ann Intern Med 48:267-282 ( (Feb) ) 1958.Crossref 14. Ellis, F.H., Jr.; Brandenburg, R.O.; and Swan, H.J.C.: Defect of the Atrial Septum in the Elderly , New Eng J Med 262:219-224 ( (Feb) ) 1960.Crossref 15. Rodstein, M.; Zeman, F.D.; and Gerber, I.E.: Atrial Septal Defect in the Aged , Circulation 23: 665-674 ( (May) ) 1961.Crossref 16. Adams, C.W.: A Reappraisal of Life Expectancy With Atrial Shunts of the Secundum Type , Dis Chest 48:357-376 ( (Oct) ) 1965.Crossref 17. Taussig, H.B.: Congenital Malformations of the Heart: II. Specific Malformations , ed 2, Cambridge, Mass: Harvard University Press, 1960, pp 613-620. 18. McGoon, D.C., et al: Atrial Septal Defect: Factors Affecting the Surgical Mortality Rate , Circulation 19:195-200 ( (Feb) ) 1959.Crossref 19. Blount, S.G., Jr.; Balchum, O.J.; and Gensini, G.: The Persistent Ostium Primum Atrial Septal Defect , Circulation 13:499-508 ( (April) ) 1956.Crossref 20. Evans, J.R.; Rowe, R.O.; and Keith, J.D.: The Clinical Diagnosis of Atrial Septal Defect in Children , Amer J Med 30:345-356 ( (March) ) 1961.Crossref 21. Coelho, E.; dePaira, E.; and Nunes, A.: Selective Angiocardiography in the Diagnosis of Atrial Septal Defect (Ostium Secundum Type) , Amer J Cardiol 7:167-175 ( (Feb) ) 1961.Crossref 22. Sheperd, J.T., et al: Clinical, Physiological and Pathological Considerations in Patients With Idiopathic Pulmonary Hypertension , Brit Heart J 19:70-82 ( (Jan) ) 1957.Crossref 23. Husson, G.S., and Wyatt, T.C.: Primary Pulmonary Obliterative Vascular Disease in Infants and Young Children , Pediatrics 23:493-506 ( (March) ) 1959. 24. Sleeper, J.C.; Orgain, E.S.; and McIntosh, H.D.: Primary Pulmonary Hypertension: Review of Clinical Features and Pathologic Physiology With a Report of Pulmonary Hemodynamics Derived From Repeated Catheterization , Circulation 26:1358-1369 ( (Dec) ) 1962.Crossref 25. Heath, D.; Whitaker, W.; and Brown, J.W.: Idiopathic Pulmonary Hypertension , Brit Heart J 19:83-92 ( (Jan) ) 1957.Crossref 26. Evans, W.; Short, D.S.; and Bedford, D.E.: Solitary Pulmonary Hypertension , Brit Heart J 19: 93-116 ( (Jan) ) 1957.Crossref 27. Kuida, H., et al: Primary Pulmonary Hypertension , Amer J Med 23:166-182 ( (Aug) ) 1957.Crossref 28. Fowler, N.O., et al: Idiopathic and Thromboembolic Pulmonary Hypertension , Amer J Med 40: 331-345 ( (March) ) 1966.Crossref

Journal

American Journal of Diseases of Children – American Medical Association

Published: Mar 1, 1969

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