[Follow-up of children with atrioventricular septal defect].

BACKGROUND

Atrioventricular septal defect (AVSD) is a complex congenital heart disease with an incidence of 0.1-0.2 per cent. We wanted to produce an overview of all children in our catchment area born with AVSD in a defined period of time and to evaluate our follow up routines in respect of AVSD.

MATERIAL AND

METHODS

The medical case-notes of 53 children born with AVSD between 1983 and 1995 were examined.

RESULTS

Eleven children had died. 42 were offered an extended examination. 36 of the 53 children (68%) had Down's syndrome; 77% (28/36) of these had complete AVSD versus 52% (9/17) of the children without Down's syndrome. The difference was not statistically significant. Children with Down's syndrome had lower maximal oxygen uptake (p = 0.01) and lower maximal pulse rate (p = 0.02). We did not find any significant association with degree of atrioventricular insufficiency, size of left atrium or pro-atrial natriuretic peptide (pro-ANP). Moreover, no association existed between the degree of atrioventricular incompetence and exercise tolerance tested on the treadmill. ECG, 24-hour ambulatory taped ECG, blood tests and chest X-ray gave no additional information.

INTERPRETATION: Children with AVSD who have been operated on, should be examined ambulatory every year or every second year. Clinical examination and echocardiography seem to be the most important aspect of the evaluation.