ORIGINAL ARTICLE The Effect on Somatic Growth of Surgical and Catheter Treatment of Secundum Atrial Septal Defects Meghan M. Chlebowski 1,3 • Hongying Dai 2 • Stephen F. Kaine 1,3 Received: 28 March 2017 / Accepted: 4 July 2017 Ó Springer Science+Business Media, LLC 2017 Abstract Historical studies suggest an association between atrial septal defect (ASD) and impaired growth with inconsistent improvement following closure. Limited data exist regarding the impact on growth in the era of transcatheter therapy. To evaluate the effect of closure on growth, we conducted a retrospective review of patients undergoing surgical or transcatheter closure during two time periods. Four hundred patients with isolated secun- dum ASD were divided into three cohorts: early surgical, contemporary surgical, and transcatheter. Data collected included demographics; height, weight, and body mass index (BMI) percentiles; catheterization hemodynamics; and co-morbidities. For all cohorts, there was no significant change in height or weight percentiles during two years after ASD closure. Age at repair was later for contempo- rary surgical and transcatheter cohorts (p \ 0.0001). In the transcatheter cohort, mean Qp:Qs was 1.65 ± 0.54, but there was no correlation between greater Qp:Qs and decreased somatic growth. Subgroup analysis for patients with any initial growth percentile \ 5th percentile demon- strated a significant change in weight and BMI percentiles in the first two years after closure (p \ 0.0004). The advent of transcatheter therapy shifted institutional practice to later age at repair for both surgical and transcatheter clo- sure. There was no significant change in weight and height percentiles during two years after closure. Only patients with initial weight and BMI \ 5th percentile had improved growth after treatment. Concern for impaired growth should not generally be an indication for early ASD repair. However, early repair may be indicated in children with existing significant growth failure. Keywords Atrial septal defect Á Congenital heart disease Á Intervention Á Growth Á Children Abbreviations ASD(s) Atrial septal defect(s) BMI Body mass index Introduction Prior studies have shown an association between the presence of an atrial septal defect (ASD) and impaired growth [1–10]. However, these same studies show an inconsistent improvement in growth following closure of the defect. In a limited study, Rhee et al. [11] reported a benefit of repair for improving height or weight by ?0.5 SD in a select group of undersized patients with ASD relative to controls. However, these data were limited only to repair of defects before 1997 and in patients with a preoperative weight or height z score B1.0 (16th per- centile). Despite variability in the existing literature, anecdotal beliefs that a subset of children with ASD have improved growth following repair still result in many children being referred for early closure. However, there are no data published regarding the effect of closure of these defects on somatic growth, particularly in the era of transcatheter device closure. The purpose of this study was to evaluate the effect on somatic growth of closure of an & Meghan M. Chlebowski mchlebowski@cmh.edu 1 Division of Cardiology, Children’s Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA 2 Division of Biostatistics, Children’s Mercy, Kansas City, MO, USA 3 Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA 123 Pediatr Cardiol DOI 10.1007/s00246-017-1678-6