Results of surgery for atrial septal defect in patients of 40 years and over

Knight, Michael; Lennox, S. C.

doi:10.1136/thx.27.5.577

Cited by 9 publications

(1 citation statement)

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“…It was thought in the 1960s that surgical correction of atrial septal defects in adults over 45 was of benefit only in those with minimal symptoms, and that operative closure after 45 years of age was of questionable value 16. Later, Knight and Lenox pointed out that a moderate increase in pulmonary artery pressure before operation (up to 65 mm Hg systolic) did not increase overall hospital mortality 14. They also claimed that operating on patients with severe pulmonary hypertension was too hazardous.…”

Section: Discussionmentioning

confidence: 99%

Do patients over 40 years of age benefit from surgical closure of atrial septal defects?

Jemielity

2001

Heart

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Objective-To determine the value of surgical closure of atrial septal defects in patients over 40 years of age. Methods-Retrospective analysis of 76 patients (63 women, 13 men), age range 40-62 years (mean (SD) 45.8 (5.1) years), who underwent surgical repair of atrial septal defect. Pre-and postoperative clinical status (New York Heart Association (NYHA) functional class) was assessed, and ECG, x ray, and echocardiographic investigations performed. Follow up was between 1 and 17 years. Results-One operative and one late death occurred during the study period. Before operation, 47 patients (61.8%) were in NYHA functional classes III and IV. After operation, 61 patients (82.4%) were in classes I and II. Four patients had atrial fibrillation before surgery versus nine after surgery. Before operation, 52 patients had intensified pulmonary vascularity compared with only seven after operation. Echocardiographic examination showed a significant reduction in right ventricular dimension (4.10 (0.91) v 2.95 (0.36) cm, p < 0.001). No residual intracardiac shunts were identified on echocardiographic follow up. Conclusions-Surgical closure of atrial septal defects in patients over 40 years old can improve their clinical status and prevent right ventricular dilatation and insuYciency. (Heart 2001;85:300-303)

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Section: Discussionmentioning

confidence: 99%