[Circulatory and respiratory systems in children after surgical correction of atrial septal defect type II (ASD II)].

The main objective of the study was to evaluate the conditions of circulatory and respiratory system 1-5 years after surgical correction of atrial septal defect (ASD II) in 112 children who had been operated at Silesian Medical Centre in Katowice in 1989-1993. Obtained results were compared with these ones found in the group of 60 healthy children. Mean age of study group was 7.78 +/- 4.46 years at the time of examination and 5.34 +/- 3.98 at the time of the operation. Twenty older children in the mean age 11 +/- 4.5 years (necessity for cooperation) were selected from the study group to perform the respiratory system tests. These tests were performed 7 days prior to operation and repeated 8 to 12 months afterwards. The following indices were determined: FVC--forced volume capacity, FRC--functional residual capacity, RV--residual volume, TLC--total lung capacity, FEV1--forced first second expiratory volume, PEF--peak expiratory flow, MEF 75-50-25% FVC--maximum expiratory flow at 75-50-25% of forced volume capacity, ITGV--intrathoracic gas volume, Raw-respiratory tract resistance, CL, st--static compliance of lung, DL, CO[SB]--lung diffusion capacity for carbon monoxide and D/VA--Krogh transfer coefficient. Circulatory system tests included: medical interview, physical examination, routine and 24-hour ambulatory ECG, echocardiography. There was found that children after ASD II closure have efficient circulatory system and most of them have normal ECHO results. Almost 40% of the children within 1 to 5 years following ASD operations have cardiac arrhythmias found in 24-hour ECG, but significant arrhythmias are seen only in 17.8% of the subjects. Most of the rhythm disturbances were mild. Significant arrhythmias and sinus node dysfunction were observed more frequently among the children who underwent surgical correction than in the healthy control group. Statistically significant deterioration of lung diffusion capacity for carbon monoxide (DL,CO[SB]) and Krogh coefficient (D/VA) has been found after the surgery. Thus, it is concluded that some pulmonary abnormalities may persist or even increase after successful ASD operation.