MEDICAL AREA   

Medicina dello Sport 2008 June;61(2):159-66

Copyright © 2008 EDIZIONI MINERVA MEDICA

language: English, Italian

Atrial septal defect (ostium secundum) and physical activity in children

Di Giacinto B. ¹, Giordano U. ¹, Cifra B. ², Turchetta A. ¹, Meta R. ², Calzolari A. ¹

¹ Cardiorespiratory and Sports Medicine Unit, Department of Pediatrics “Bambino Gesù” Children’s Hospital Rome, Italy 2 School of Specialization in Sport Medicine, University “Tor Vergata”, Rome, Italy

Aim. Atrial septal defect is from 6% to 10% of congenital heart diseases at birth and is the most common congenital heart defect in adulthood. The quality of life of these children has significant importance also to permit them the practice of physical activity as healthy children. Aim of our study was to evaluate cardiorespiratory functional assessment in children with diagnosed atrial septal defect (ostium secundum) after patch closure to establish the possibility to practice physical activity also at competitive level.
Methods. Ninty three patients with atrial septal defect II type underwent patch closure at our Hospital (44 males and 49 females). Mean age at the first observation was 8 ± 2,7 years for males and 9 ± 3 years for females (range from 4 to 14 years). The mean duration of follow-up was 4,6 ± 3,5 years. All subjects underwent: physical examination with the measurement of blood pressure at rest using a calibrated Tycos aneroid sphygmomanometer; electrocardiogram at rest (12 leads); colour-Doppler echocardiogram following the ACC/AHA/AAP recommendations; 24 hours Holter monitoring and exercise testing on treadmill following the Bruce protocol with the measurement of time of exercise, maximal heart rate and maximal systolic blood pressure. Control group: 186 healty children examined in our laboratory.
Results. In 78 patients an incomplete right bundle-branch block was found while in 17/93 (17 %) patients simple arrhythmias were observed during 24-h Holter monitoring. Majority of patients presented a statistically significant reduction in time duration during exercise testing respect to control group, even if the difference decreased progressively in follow-up (aboveall in female patients). No deaths or major complications occurred.
Conclusion. We can conclude that most of patients after surgical repair for atrial septal defect II type can practice physical activity also at competitive level without significant risks for their life. An accurate yearly functional evaluation is needed.