Asd in Patients Over 40 Years of Age

Abstract

To evaluate the benefits of operative treatment of congenital heart disease in older age groups, a clinical study on patients over 40 years of age with atrial septal defect was carried out. The series consisted of 125 consecutive patients operated on between 1966 and 1974. There were 8 cases with a primum, 12 cases with a sinus venosus type of secundum and 105 cases with a simple secundum defect. The operative mortality was 2 patients (1.6%). It was due to myocardial infarction in one case and high pulmonary vascular resistance in the other. On re-examination 3-6 months postoperatively, 107 patients were improved, 13 patients unchanged and 3 patients were worse than before operation. On re-evaluation after an average period of 6 years, 88 patients were still improved. 32 patients unchanged and 3 patients were worse compared with their pre-operative status. On the basis of the results and the previous reports on atrial septal defect without operation, the surgical correction of ASD even in older age groups can be recommended. The problem of deterioration of some patients, despite a good immediate postoperative result, is discussed.

Intracardiac Echo‐Guided Radiofrequency Catheter Ablation of Atrial Fibrillation in Patients with Atrial Septal Defect or Patent Foramen Ovale Repair: A Feasibility, Safety, and Efficacy Study

“…The Maze procedure performed at the time of closure of an ASD is feasible and is associated with a good short‐term and intermediate‐term maintenance of sinus rhythm 10,16–18 . With advancements in percutaneous techniques, a larger number of patients with ASDs and PFOs are undergoing device closures, and 41–59% of these subjects are at future risk for AF, requiring a therapeutic intervention 9,11,12,19 . As is clearly shown in our study, percutaneous AF ablation is not only feasible but also has excellent success rates comparable with age‐gender matched controls.…”

“…AF is common among patients with atrial septal defects (ASD) and often persists despite surgical or transcatheter closures 7–12 . After corrective treatment, some of these patients may develop new‐onset AF years later.…”

“…AF is common among patients with atrial septal defects (ASD) and often persists despite surgical or transcatheter closures. [7][8][9][10][11][12] After corrective treatment, some of these patients may develop new-onset AF years later. The obliteration of the fossa ovalis by surgical patches or percutaneous closure devices presents a unique challenge to the operator performing the transseptal punctures for left atrial instrumentation.…”

Atrial Arrhythmia after Surgical Closure of Atrial Septal Defects in Adults

“…1,4,5 Atrial flutter or fibrillation, however, has often persisted at late follow-up (>25 years) in patients who have undergone surgical closure after childhood (reported incidence, 41 to 59 percent). 1,[4][5][6][7] Evidence suggests that the Cox maze procedure, 8 performed at the time of closure of an atrial septal defect, is feasible and is associated with good shortterm and intermediate-term maintenance of sinus rhythm. [9][10][11] This finding has led several groups to advocate the use of surgical procedures to target atrial flutter and fibrillation at the time of the surgical repair of an atrial septal defect in patients considered to be at high risk for these arrhythmias.…”

Surgical Repair for Atrial Septal Defect in Patients over 70 Years of Age.

“…[4][5][6][7][8][9] For patients aged over 60 years, acceptable operative mortality and symptomatic improvement following surgery have been reported despite a higher incidence of postoperative complications. [10][11][12] In this study, we reviewed patients with ASD aged over 70 years and studied their preoperative hemodynamics, the surgical procedures used and the results in order to evaluate the risks and benefits of surgery for ASD.…”