Late postoperative follow-up of ostium secundum defect

To perform late postoperative assessment of patients with ostium secundum defect.

We studied 45 patients 22+/-4 years after operation using clinical examination, transthoracic and transoesophageal echocardiography and electrocardiography.

Patients operated on at 24 years reported dyspnoea upon exercise. Mitral regurgitation occurred more frequently in patients operated on at 24 years (29% vs 69%, P<0.05). Tricuspid regurgitation was mild in 20 patients (45%). There was an inter-atrial communication in 13 patients (28%). Eighteen patients (40%) had an enlarged right ventricular diameter. A tricuspid regurgitation gradient >30 mmHg was measured in seven patients (16%). Seventeen patients (38%) had significant electrocardiographic abnormalities.

Late after uncomplicated seclusion of ostium secundum defect patients operated at >24 years have more symptoms than those operated on at an earlier age. Residual lesions are common. Mitral regurgitation is more frequent in patients operated on at >24 years. Our findings support the clinical consensus of operating on these patients in their childhood and adolescence.