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Paediatric follow-up of haemodynamically insignificant congenital cardiac lesions

Smith BG et al. – The increasingly sensitive and advanced nature of echocardiography and the subsequent reliance upon it may be contributing to unnecessarily frequent review of haemodynamically insignificant congenital cardiac lesions (HICCL) and a reluctance to discharge patients. In the majority of patients with HICCL, no more than two assessments of HICCL are required after 2 years of age – once in late childhood and once near full growth.

Methods
  • An internet-based survey of 170 paediatric cardiologists and general paediatricians with an interest in cardiology in the UK.
  • Five scenarios concerning common HICCL were presented: ventricular and atrial septal defects, patent foramen ovale, mild pulmonary stenosis and persistent ductus arteriosus.

Results
  • There were 52 respondents.
  • There was a broad range of beliefs and practices. However, there were tendencies to discharge children with a patent foramen ovale and follow patients with all other lesions, often on a relatively frequent basis.
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