title: Recall of patients discharged from follow-up after repair of isolated congenital shunt lesions.
abstract: BACKGROUND
  Discharge from follow-up after closure of isolated congenital shunt lesions in childhood was common practice in the past. The aim of the present study was to recall these patients to evaluate their current status.
  
  
  METHODS
  Patients included in the database of pediatric and congenital heart disease of our tertiary center with repaired secundum atrial septal defect (ASD) or ventricular septal defect (VSD) before the age of 18years, and discharged from follow-up, were invited for clinical and echocardiographic check-up.
  
  
  RESULTS
  Forty-six ASD patients (age 30±7years, 37% male) responded. Median age at ASD repair was 6 (IQR 4-8) years. All but one functioned in NYHA class I. Eight (17%) patients reported palpitations. No patient developed pulmonary hypertension (PH). Right ventricular (RV) dilatation was present in 7 (15%). RV fractional area change (FAC) was <35% in 7 (15%), TAPSE <17mm in 12 (26%). Forty-seven VSD patients (age 34 (IQR 29-40) years, 57% male) participated. Median age at VSD repair was 4 (IQR 1-5) years. Six (13%) patients functioned in NYHA class II. Seventeen (36%) patients reported palpitations. Four (9%) patients presented PH. Left ventricular dilatation was present in 4 (9%), RV dilatation in 6 (13%). RV FAC was <35% in 7 (15%), TAPSE <17mm in 17 (36%). Seven (15%) patients had dilated ascending aorta.
  
  
  CONCLUSIONS
  Patients with closure of isolated secundum-type ASD in childhood do well, but some have persistent RV dilatation and dysfunction. By contrast, more patients after VSD closure were symptomatic and presented with RV dilatation and dysfunction, PH, and a dilated ascending aorta.
authors.affiliation: Department of Cardiovascular Sciences, KU Leuven-University of Leuven, Leuven, Belgium; Department of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Charlien
authors.initials: C
authors.lastname: Gabriels
authors.affiliation: Department of Cardiovascular Sciences, KU Leuven-University of Leuven, Leuven, Belgium; Department of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Alexander
authors.initials: A
authors.lastname: Van De Bruaene
authors.affiliation: Department of Cardiovascular Sciences, KU Leuven-University of Leuven, Leuven, Belgium; Department of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Frederik
authors.initials: F
authors.lastname: Helsen
authors.affiliation: Department of Public Health and Primary Care, KU Leuven-University of Leuven, Leuven, Belgium; Institute of Health and Care Sciences, University of Gothenburg, Sweden.
authors.forename: Philip
authors.initials: P
authors.lastname: Moons
authors.affiliation: Department of Cardiovascular Sciences, KU Leuven-University of Leuven, Leuven, Belgium; Department of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Kristien
authors.initials: K
authors.lastname: Van Deyk
authors.affiliation: Department of Cardiovascular Sciences, KU Leuven-University of Leuven, Leuven, Belgium; Department of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Els
authors.initials: E
authors.lastname: Troost
authors.affiliation: Department of Cardiovascular Sciences, KU Leuven-University of Leuven, Leuven, Belgium; Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: Meyns
authors.affiliation: Department of Cardiovascular Sciences, KU Leuven-University of Leuven, Leuven, Belgium; Department of Paediatrics, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Gewillig
authors.affiliation: Department of Cardiovascular Sciences, KU Leuven-University of Leuven, Leuven, Belgium; Department of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium. Electronic address: werner.budts@uzleuven.be.
authors.forename: Werner
authors.initials: W
authors.lastname: Budts
mesh_terms: D000328:Adult; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D010351:Patient Discharge / Q000639:trends*
keywords: Adult congenital heart disease; Atrial septal defect; Discharge from follow-up; Hemodynamics; Transthoracic echocardiography; Ventricular septal defect