Patency of neonatally identified interatrial communications in young children
Presented By:
Sofie Dannesbo, Anna Maria Dehn, Ruth Ottilia Birgitta Vogg, Heather Boyd, Finn Stener Jorgensen, Vibeke Hjortdal, Anne-Sophie Sillesen, Anna Axelsson Raja, Niels Vejlstrup, Kasper Iversen, Henning Bundgaard
Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Denmark
sofie.dannesbo.01@regionh.dkOverview:
Introduction: Atrial septal defects (ASDs) of the secundum type are some of the most common cardiac abnormalities. However, in newborns, ASDs are challenging to distinguish from normal physiological interatrial communications (IACs) within the oval fossa, i.e. patency of the oval foramen (PFO). On this basis, an algorithm for classification of neonatal IACs identified using transthoracic echocardiography was recently developed. In the present study we investigated the patency of neonatally identified IACs categorized by the algorithm as ASDs or PFOs in young children.
Methods: Children, who had an IAC detected during the first month after birth through participation in the Copenhagen Baby Heart Study, were offered a follow-up echocardiogram at 4-5 years of age. Children with other cardiac abnormalities, born premature, with low birth weight, from a multiple pregnancy, or born to mothers with either pregestational or gestational diabetes or hypertensive disorders of pregnancy, were excluded from the study. The neonatally identified IACs was categorized as either PFO or ASD according to the algorithm. The follow-up echocardiograms were assessed for patency of an IAC by a single operator blinded to the neonatal IAC subtype.
Results: Currently, 81 children (median age 4.5 [interquartile range 4.4-4.7] years, 64% female) have been examined. Neonatally, the IACs were classified as ASDs in 36 newborns and PFOs in 45 newborns. The follow-up echocardiogram showed patency of the IAC in 14 of the children with an ASD (39%) and in 9 of the children with PFO (20%), (p=0.06). We aim to examine a total of 1,200 children.
Conclusion: These preliminary findings suggest numerically – although not yet statistically significant – twice as many ASDs as PFOs remain patent in children examined at 4-5 years of age. This finding supports the potential value of the novel diagnostic algorithm.
Methods: Children, who had an IAC detected during the first month after birth through participation in the Copenhagen Baby Heart Study, were offered a follow-up echocardiogram at 4-5 years of age. Children with other cardiac abnormalities, born premature, with low birth weight, from a multiple pregnancy, or born to mothers with either pregestational or gestational diabetes or hypertensive disorders of pregnancy, were excluded from the study. The neonatally identified IACs was categorized as either PFO or ASD according to the algorithm. The follow-up echocardiograms were assessed for patency of an IAC by a single operator blinded to the neonatal IAC subtype.
Results: Currently, 81 children (median age 4.5 [interquartile range 4.4-4.7] years, 64% female) have been examined. Neonatally, the IACs were classified as ASDs in 36 newborns and PFOs in 45 newborns. The follow-up echocardiogram showed patency of the IAC in 14 of the children with an ASD (39%) and in 9 of the children with PFO (20%), (p=0.06). We aim to examine a total of 1,200 children.
Conclusion: These preliminary findings suggest numerically – although not yet statistically significant – twice as many ASDs as PFOs remain patent in children examined at 4-5 years of age. This finding supports the potential value of the novel diagnostic algorithm.
