Atrial septal defect in patients over 45 years of age. Merits of surgical versus medical therapy.

Wolf, Phillip S.; Vogel, John H.K.; Pryor, Ray; Blount, S. Gilbert

doi:10.1136/hrt.30.1.115

Cited by 38 publications

(8 citation statements)

References 16 publications

(8 reference statements)

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“…It is, however, in fairly good agreement with other reports [6,20,21,27,28,32,33] on adult patients, supporting the concept that the frequency of these abnormalities increases with age [7,28]. After surgery the overall frequency of arrhythmias was markedly reduced, although it was higher than in the patients operated on during childhood [2,22].…”

Section: Discussionsupporting

confidence: 79%

Electrocardiographic Findings before and after Surgery for Atrial Septal Defect of the Secundum Type in Middle-Aged Patients

Forfang¹

1978

Cardiology

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Surgery for atrial septal defect of the secundum type was performed in 84 patients over 40 years of age. Electrocardiograms were studied preoperatively and at a follow-up visit 74 months (range 22–174 months) after surgery. Preoperatively, atrial fibrillation was observed in 13% of the patients, complete right bundle branch block in 30%, and a secondary R wave (R’) in lead V₁ in 72%. A significant correlation was found between the amplitudes of S V₆ and R’V₁ and the right ventricular systolic pressure, whereas no significant correlation could be demonstrated between the shunt ratio and any of the QRS parameters. After successful surgery, the mean QRS axis in the frontal plane shifted from +99° to +47° (p < 0.01), and the following highly significant (p < 0.001) changes were noticed: increase of the amplitude of S V_1’ shortening of the QRS duration in V_1’ increase of the ratio QR’/QRS V_1’, shortening of the duration of S V_6’ and diminution of the initial forces of the P wave in V₁.

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Section: Discussionsupporting

confidence: 79%

Electrocardiographic Findings before and after Surgery for Atrial Septal Defect of the Secundum Type in Middle-Aged Patients

Forfang¹

1978

Cardiology

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“…[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.…”

mentioning

confidence: 99%

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

et al. 1997

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SUMMARYAtrial septal defect (ASD) is the most common congenital heart anomaly encountered in adults. For patients over 60 years old, acceptable operative mortality and symptomatic improvement following surgery have been reported. We reviewed patients with ASD aged over 70 years and studied their preoperative hemodynamics, the surgical procedures used and the results.Between January 1994 and December 1996, 18 patients over the age of 40 years underwent surgical repair of ASD. Four patients were over 70 years of age (Group A). The other 14 patients were studied as a control group (Group B). We compared the preoperative clinical status, hemodynamic data, and surgical results between the two groups. The postoperative clinical status of Group A was studied during the follow-up period.The NYHA functional class of the elderly patients was greater than that of the middle-aged patients. None of the elderly patients had pulmonary hypertension. Moderate or severe tricuspid valve regurgitation (TR) due to annular dilatation was found, and tricuspid annuloplasty was performed in all four elderly patients. There were no operative or hospital deaths in either group. The NYHA functional class and TR improved in all the aged patients after surgery.In order to prevent progressive tricuspid annular dilatation due to an intraatrial left to right shunt, surgical closure of ASD should be performed for physically active adult patients. (Jpn Heart J 1997; 38: 677-684)

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“…John Sutton et al, 1981;Wolfef ul., 1968). Although the immediate perioperative mortality has been lowered (Dave et al, 1973;Nasrallah et al, 1976), the long-term survival may be similar (Wolf et al, 1968), and may be affected by other coexistent diseases. A recent long-term postoperative study in adults over age 60 showed symptomatic benefit and increased longevity, regardless of preoperative pulmonary artery pressure or pulmonary vascular resistance (St. John Sutton et al, 1981).…”

Section: Discussionmentioning

confidence: 99%

Atrial septal defect in adult identical twins: A variation in theme

Macdonald

Mcmurtry

Dodek

1983

Clinical Cardiology

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Summary:The diagnosis of atrial septal defect was established in monozygotic twin females at age 63. Each patient mimicked a different acquired heart disease. One twin had congestive heart failure and atrial fibrillation and was diagnosed as having rheumatic mitral insufficiency. The other twin had atypical chest pain and systemic hypertension and was thought to have arteriosclerotic heart disease. In each case the correct diagnosis was made at cardiac catheterization. Although the same basic congenital heart lesion was present in both patients, the symptoms and findings differed. Symptomatic improvement was achieved by different therapeutic modalities. One patient had open heart surgery, while the other twin improved with medical therapy.

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Atrial septal defect in patients over 45 years of age. Merits of surgical versus medical therapy.

Cited by 38 publications

References 16 publications

Electrocardiographic Findings before and after Surgery for Atrial Septal Defect of the Secundum Type in Middle-Aged Patients

Electrocardiographic Findings before and after Surgery for Atrial Septal Defect of the Secundum Type in Middle-Aged Patients

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

Atrial septal defect in adult identical twins: A variation in theme

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