Fukazawa M, Fukushige J, Ueda K
Department of Pediatrics, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Am Heart J. 1988 Jul;116(1 Pt 1):123-7. doi: 10.1016/0002-8703(88)90259-1.
Early diagnosis of atrial septal defects (ASDs) by means of two-dimensional echocardiography has facilitated studies on the natural course of this lesion. Among 12 Japanese infants in whom a diagnosis of opening of the atrial septum was made in the neonatal period, eight had spontaneous closure at age 2 to 16 months, as shown by two-dimensional echocardiography. To study the exact incidence and natural course of atrial openings in the neonatal period, another 102 consecutive infants from two neonatal care units were followed prospectively with the use of two-dimensional echocardiography. Atrial openings were evident in 24 infants (24%) within the first week of life, in 13 (13%) older than 1 week, in seven (7%) older than 1 month, in five (5%) older than 6 months, and in two (2%) older than 1 year. Twenty-eight of the 30 infants with spontaneous closure in both groups had valvelike openings of the atrial septum that closed by fusion of the valves. ASDs that closed spontaneously in infants with clinical signs and symptoms of atrial shunt may be the same clinical entity as the valvelike openings of the atrial septum frequently observed in neonates with few clinical symptoms and may be differentiated morphologically from ASDs with openings without valve formation, which have little tendency to close.
通过二维超声心动图对房间隔缺损（ASD）进行早期诊断，有助于对该病变自然病程的研究。在12名新生儿期诊断为房间隔开放的日本婴儿中，二维超声心动图显示，8名婴儿在2至16个月时自然闭合。为了研究新生儿期房间隔开放的确切发生率和自然病程，对来自两个新生儿重症监护病房的另外102名连续婴儿进行了前瞻性二维超声心动图随访。出生后第一周内有24名婴儿（24%）出现房间隔开放，1周以上的有13名（13%），1个月以上的有7名（7%），6个月以上的有5名（5%），1岁以上的有2名（2%）。两组中30名自然闭合的婴儿中有28名有瓣膜样房间隔开口，通过瓣膜融合而闭合。有房分流临床体征和症状的婴儿中自然闭合的ASD，可能与在几乎没有临床症状的新生儿中经常观察到的瓣膜样房间隔开口是同一临床实体，并且在形态上可能与没有瓣膜形成的开口的ASD相区别，后者几乎没有闭合的倾向。
