The results of surgery for atrial septal defect in patients

Abstract

We examined the cases of 31 patients over the age of 50 years undergoing operative closure of isolated ostium secundum atrial septal defect. The lesion had been diagnosed in all cases prior to cardiac catheterization. To assess the importance of pre-operative data on surgical outcome, the patients were first divided into three groups according to mean pulmonary artery pressure (PAP): less than 16 mmHg (Group A), 16-30 mmHg (Group B) and greater than 30 mmHg (Group C). Symptomatic improvement occurred in all groups but more patients in Group C, although symptomatically improved, remained short of breath and in atrial fibrillation than in Group A. Patients in Group A had a higher actual forced vital capacity expressed as a percentage of the predicted value (FVCa/FVCp) than patients in Group B or Group C (P less than 0.015). There was a good correlation between FVCa/FVCp and percentage oxygen saturation of the arterial blood (P less than 0.0009). This simple non-invasive investigation was therefore found to correlate with previously documented parameters, pulmonary artery pressure and percentage oxygen saturation of the arterial blood, affecting surgical outcome. Patients were also divided into groups according to FVCa/FVCp: less than 75% (Group 1), 50-75% (Group 2) and less than 50% (Group 3). Postoperative symptoms were more common in Group 3 than in Group 1. We conclude that respiratory function tests, as well as measurement of pulmonary artery pressures, are useful in predicting improvement following atrial septal repair.

Atrial septal defect closure is associated with a reduced prevalence of atrial tachyarrhythmia in the short to medium term: a systematic review and meta-analysis

“…Eleven studies7 13–20 23 29 30 32 reported AT prevalence at mid-term follow-up (30 days–5 years), with an OR of 0.47 (95% CI 0.36 to 0.62). Eleven studies4 21 22 25–28 31 33 34 reported the results of long-term follow-up (>5 years).…”

Atrial natriuretic peptide levels in adult patients before and after surgery for correction of atrial septal defects: relationship with atrial arrhythmias

“…ASD is frequently associated with atrial arrhythmias, especially AF (atrial fibrillation) [5][6][7]. AF is a common arrhythmia found in conjunction with ASD, particularly in adults, and is a significant cause of morbidity [5][6][7].…”

“…AF is a common arrhythmia found in conjunction with ASD, particularly in adults, and is a significant cause of morbidity [5][6][7]. Although the incidence of AF increases with age, even in the general population [8], the incidence of AF in patients with ASD is strikingly high even after surgical closure [9,10].…”

“…On the other hand, surgical closure of ASD rarely eliminates chronic AF once it has persisted for more than a year [6]. The reason for recommending early surgical closure of ASD, in addition to prevention of cardiac failure and pulmonary hypertension, is to prevent atrial arrhythmias arising when the patient becomes older [6][7][8].…”

Interaction of the Heart and Lungs During Exercise: Physiology and Pathophysiology in Children with Congenital Heart Disease

“…Therefore, the authors recommended early surgical or device closure. However, in patients of all ages, surgical closure of atrial septal lesions is associated with subjective improvement in symptoms with exercise, overall exercise capacity, and New York Heart Association functional classification [35][36][37][38].…”