Drożny otwór owalny i ubytek przegrody międzyprzedsionkowej typu wtórnego – znaczenie i postępowanie u dzieci

Izabela Janiec¹, Beata Kucińska², *Bożena Werner²

Summary
Foramen ovale is a very important part of fetal circulation. In postnatal life the closure occurs usually during the first 3 months. If is still present after the age of 3 months, the diagnosis of persistent foramen ovale (PFO) is established. Persistent foramen ovale is present in 25-30% of general population. It causes transient shunt between atrias due to insufficiency of foramen ovale valve. Children with uncomplicated PFO do not require any treatment nor pediatric cardiologist supervision.
Secundum atrial septal defect (ASD II) is one of the most common congenital heart defects. It is a communication between the atrias. Hemodynamically significant ASD leads to right atrial and right ventricular enlargement, dilatation of the pulmonary trunk and the increase of pulmonary to systemic flow ratio. In typical clinical course of isolated defects symptoms begin in adulthood and include fatigue, right ventricular failure, arrhythmia, and risk of pulmonary hypertension. Children usually are asymptomatic and even the defect with significant shunt may be diagnosed late. ASD II with hemodynamically significant shunt does not require urgent closure. Small defects are used to close spontaneously, bigger ones are rather prone to enlarge. The treatment of choice is percutaneous procedure. Surgical treatment can be indicated in infants and in patients with defects too big in size or with localization not suitable for interventional treatment.

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