Elective closure of atrial septal defect (ASD) is usually recommended during preschool ages. However, ASD may contribute to deteriorating health in the presence of significant comorbidity and, thus, may need earlier closure. There is a lack of clarity regarding the indications for and outcomes after ASD closure in infancy and early childhood. We investigated the benefits and safety of surgical ASD closure in symptomatic patients under 2 years of age. Retrospective chart review was conducted in patients who underwent surgical ASD closure within the first 2 years of life. Of 31 symptomatic ASD patients, 22 had persistent respiratory symptoms, 24 failure to thrive, and 9 pulmonary hypertension. Overall, 26 patients (84.0%) showed clinical improvement after ASD closure, including improved respiratory status (17/22; 77.3%), resumption of normal growth (15/24; 62.5%), and resolution of pulmonary hypertension (7/7; 100%, 2 patients unable to assess postoperatively). Two medically complicated patients died a few months after surgery unrelated to surgical complications. Four out of 8 ventilator-dependent patients were weaned from mechanical ventilation within 1 month after ASD closure. Closure of ASD did not improve those patients with highly advanced lung disease and/or medically complex conditions including underlying genetic abnormalities. Surgical complications were uncommon. Postoperative hospital stay was 4 to 298 days (median 8 days). The majority of our patients demonstrated significant clinical improvement after ASD closure. Early ASD closure is safe and beneficial for symptomatic infants and young children with associated underlying pulmonary abnormalities, especially bronchopulmonary dysplasia.

中文翻译：

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早期手术闭合房间隔缺损可改善有症状的有肺部异常症状的幼儿的临床状况。

通常建议在学龄前选择性关闭房间隔缺损（ASD）。但是，在严重合并症的情况下，ASD可能会导致健康恶化，因此可能需要更早关闭。关于婴儿期和幼儿期ASD封堵后的适应症和结局缺乏明确性。我们调查了2岁以下有症状患者的手术ASD封闭的益处和安全性。回顾性图表回顾是在生命的头2年内接受了外科ASD封闭的患者中进行的。在31例有症状的ASD患者中，有22例持续出现呼吸道症状，24例无法壮成长和9例肺动脉高压。总体而言，有26例患者（84.0％）在ASD闭合后显示出临床改善，包括呼吸状况得到改善（17/22; 77.3％），恢复正常生长（15/24; 62.5％），以及解决肺动脉高压（7/7; 100％，2名患者无法进行术后评估）。两名内科复杂的患者在手术后几个月死亡，与手术并发症无关。ASD闭合后1个月内，每8名依赖呼吸机的患者中有4名断奶。封闭ASD不能改善那些高度晚期肺部疾病和/或医学上复杂的疾病，包括潜在的遗传异常的患者。手术并发症并不常见。术后住院时间为4至298天（中位数为8天）。我们的大多数患者在ASD闭合后表现出明显的临床改善。早期ASD封闭对于有症状的潜在肺部异常的有症状婴儿和幼儿是安全且有益的，