Ostium Secundum Atrial Septal Defect in the Elderly

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 symptoms. Given the higher risks and poorer long-term results of surgical closure of the defect in advanced age, the indications for such an intervention in elderly patients should be carefully evaluated.

An Unusual Presentation of Atrial Septal Defect in a Patient Undergoing Total Hip Arthroplasty

“…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.…”

Congenital Heart Diseases in Aged Patients

“…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.…”

Hämodynamisch wirksamer Vorhof-Septum-Defekt Typ II bei einer 78-jährigen Patientin

“…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.…”

“…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.…”