Study Of Children<2 Years Old With Atrial Septal Defect After Interventional Closure

Objective: 1.To investigate whether the incidence of complications after interventional closure of atrial septal defect in children < 2 years old is different from that in children ? 2 years old.2.To investigate whether there are differences between postoperative recovery of children < 2 years old and children ? 2 years old.3.To explore whether interventional closure of atrial septal defect as early as possible can promote the growth and development of children.Methods: The clinical data of 235 children undergoing interventional closure of atrial septal defect in heart center of Qingdao women and children's hospital from July 2009 to June 2019 were retrospectively analyzed,and they were divided into experimental group(age < 2 years old,95 cases)and control group(age ? 2 years old,140 cases).Inclusion criteria: 1.Children with simple interventional closure of atrial septal defect;2.Not combined with other cardiac malformations to be treated;3.No combination of endocrine diseases,genetic and metabolic diseases,nutrient deficiency-related diseases.By collecting of hospitalization,outpatient follow-up information,collection of two groups of children with medical history,chest X-ray,electrocardiogram,echocardiography and laboratory examination(biochemical package,coagulation routine and complete blood count)data,statistical complications(residual shunt,arrhythmia,vascular complications),echocardiography and electrocardiogram changes;Data of height and weight of children aged 6 months old and 3 years old in the two groups were collected.SPSS Statistics 25 software was used for analysis.The enumeration data were expressed as percentage or rate and were compared by chi-square test.The normality analysis and homogeneity of variance analysis of the measurement data showed that all the data in this study were consistent with the normal distribution,and the results were expressed as mean ± standard deviation.The data were compared using the t-test of two independent samples.Pearson correlation analysis was used for correlation analysis.Bartlett sphericity test was used for the follow-up data.P<0.05 was considered statistically significant.Results: the preoperative biochemical package,coagulation routine and complete blood count were all in the normal range in the two groups,and the differences were not statistically significant(all P > 0.05).There was no statistically significant difference in the size of atrial septal defect,cardiothoracic ratio,left ventricular ejection fraction,number of cases of increased lung blood,and number of cases of narrowed anterior cardiac space between the two groups(all P > 0.05).However,the number of cases of right ventricular enlargement in the experimental group was significantly less than that in the control group,and the difference was statistically significant(P < 0.05).The two groups of children were followed up for 6 months to 3 years after the operation,and no fatal complications occurred.No other complications such as the loss of occlusive device and vascular complications occurred.Incomplete right bundle branch block,malignant arrhythmia,and residual shunt occurred in both groups after surgery,with no statistically significant difference(all P > 0.05).Postoperative follow-up data: the changes in left ventricular ejection fraction,white blood cell count,hemoglobin,and platelet count were not statistically significant(all P > 0.05).The correlation between ASD size and 6-month-old growth index was compared.There was no correlation between ASD and height,weight,Z value,BSA,BMI(P > 0.05).After the ASD size was corrected and the influence of BSA was removed,there was correlation among height,weight,Z value,BSA and other indexes(P < 0.05),and there was no significant difference between BMI indexes(P > 0.05).There was no significant difference in the growth and development evaluation values between the two groups at the age of 6 months old(all P > 0.05),and the Z values of height and weight were negative at the age of 6 months old.The height,weight,and Z-value of the children in the control group at the age of 3 years old were all lower than those in the experimental group,with statistically significant differences(all P < 0.05).The Z value of the same children in the experimental group was positive at the age of 3 years old and 6 months old,and the difference was statistically significant(P < 0.05).The Z value of the children in the control group was negative at the age of 3 years old and 6 months old,and the difference was statistically significant(P < 0.05).Conclusion: the height and weight development of children with atrial septal defect lag behind that of normal children.The height and weight of children < 2 years old after the interventional closure of atrial septal defect showed catchup growth.By the time they were 3 years old,their height and weight were close to or above the normal level of children of the same age and were significantly higher than those who were not operated on or aged ? 2 years old.Early interventional closure of atrial septal defect is beneficial for height and weight gain.There was no significant difference in the incidence of postoperative complications between the two groups,and there was no significant difference in postoperative cardiac function and recovery of complications.If the age is less than 2 years old,surgical treatment will not increase the incidence of surgical complications or affect the postoperative recovery.Compared with children aged ? 2 years old,the safety and efficacy of interventional plugging surgery were not significantly different,but the growth and development benefits were significantly increased.Interventional closure is recommended for children with atrial septal defect without self-healing to promote better height and weight gain.