Abstract:Atrial septal defect (ASD) is one of the most common congenital cardiac anomalies in adults. Life expectancy is shortened, and almost 90% of patients die by the age of 60 years. The progression of this congenital disease to congestive heart failure has been related to several factors such as the onset of pulmonary hypertension, arrhythmias, bronchopulmonary infections, or the development of other cardiovascular disease. We describe three cases of very old patients with significant ASDs and late development of … Show more
“…Considered one of the most common congenital cardiac anomalies in adults, ASD is seldom diagnosed beyond age 70 years, but there are rare reported cases (5)(6)(7)(8). The physiology of ASD involves a left-to-right shunt that develops early in infancy, after the fetal right ventricular hypertrophy and pulmonary vascular resistance decrease postnatally.…”
Atrial septal defect is usually diagnosed and surgically repaired in childhood. We present a case of previously asymptomatic atrial septal defect that presented during total hip arthroplasty during general anesthesia in a 72-yr-old woman. Intraoperative transesophageal echocardiography assisted in the diagnosis and in determining the appropriate treatment.
“…Considered one of the most common congenital cardiac anomalies in adults, ASD is seldom diagnosed beyond age 70 years, but there are rare reported cases (5)(6)(7)(8). The physiology of ASD involves a left-to-right shunt that develops early in infancy, after the fetal right ventricular hypertrophy and pulmonary vascular resistance decrease postnatally.…”
Atrial septal defect is usually diagnosed and surgically repaired in childhood. We present a case of previously asymptomatic atrial septal defect that presented during total hip arthroplasty during general anesthesia in a 72-yr-old woman. Intraoperative transesophageal echocardiography assisted in the diagnosis and in determining the appropriate treatment.
“…4,5 Atrial septal defect is 1 of the most common congenital cardiac abnormalities in adults and accounts for 7% of all cardiac abnormalities: life expectancy is shortened and almost 90% of patients die by the age of 60. 6,7 Atrial septic aneurysm (ASA) has an incidence of approximately 1.6% to 2.2% at a mean age of 63 years and is associated in 32% of cases with a patent foramen ovale (PFO). 8,9 CAAs occur in 0.64% to 5.6% of patients undergoing coronary angiography.…”
Patients with CHDs, especially those with low mortality in childhood, are more frequently reaching old age. New imaging techniques and endovascular treatments seem useful in the challenging management of CHDs in aged patients.
“…Lebensjahr mit Dyspnoe, Leistungsminderung und pulmonalen Infekten symptomatisch. Im arithmetischen Mittel erreichen diese Patienten ohne Intervention wie eingangs erwähnt ein Lebensalter von 35-40 Jahren (7,9). Nach der Intervention konnten wir dopplerechokardiografisch einen Rückgang der systolischen pulmonalarteriellen Druckwerte binnen 4 Wochen von initial 80 mmHg auf 30 mmHg dokumentieren.…”
Section: Diskussionunclassified
“…Die Inzidenz eines ASD wird in der Literatur mit 7-8% bezogen auf alle Lebendgeburten mit Herzfehler angegeben (12). Die durchschnittliche Lebenserwartung ohne Intervention liegt bei 35-40 Jahren (7,9), wobei das Rechtsherzversagen, maligne Arrhythmien und Thromboembolien die Hauptursachen einer erhöhten Mortalität darstellen.…”
This case is remarkable in that a very large ASD was asymptomatic up into old age and without the development of an Eisenmenger reaction. Also, large ASD can be by catheterization with the appropriate closure device. Fixed pulmonary hypertension is not obligatory. Non-invasive closure is a good alternative of surgery in elderly patients with risk factors.
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