Surgery>>>>>Congenital Heart Disease
Question 2#

The most common age to close asymptomatic ASDs is:

a. In the immediate newborn period
b. After the child reaches 10 kg in weight
c. Age 4-5 years
d. During puberty

Correct Answer is C

Comment:

ASDs are closed when patients are between 4 and 5 years of age. Children of this size can usually be operated on without the use of blood transfusion and generally have excellent outcomes. Patients who are symptomatic may require repair earlier, even in infancy. Some surgeons, however, advocate routine repair in infants and children, as even smaller defects are associated with the risk of paradoxical embolism, particularly during pregnancy. Reddy and colleagues, report 116 neonates weighing less than 2500 g who underwent repair of simple and complex cardiac defects with the use of cardiopulmonary bypass and found no intracerebral hemorrhages, no long-term neurologic sequelae, and a low operative-mortality rate (10%). These results correlated with the length of cardiopulmonary bypass and the complexity of repair. These investigators also found an 80% actuarial survival at 1 year and, more importantly, that growth following complete repair was equivalent to weight-matched neonates free from cardiac defects.