Early systemic hypertension after surgical closure of atrial septal defect

The systemic haemodynamic changes occurring in the immediate post-operative period were examined in a series of patients undergoing closure of atrial septal defect (A.S.D.) and in a consecutive series of all patients undergoing open-heart surgery in this Unit. Significant systemic hypertension was observed in 47.5% of patients in the A.S.D. series. In an attempt to explain this finding, several other haemodynamic variables were examined in relation to the systemic blood pressure. There was no correlation between central venous pressure or blood loss and systemic blood pressure. However, there was an inverse correlation between blood balance and systolic and diastolic blood pressure at 4 hours after operation. The explantation of this finding is unclear but it may be due to the effects on atrial receptors of lower right atrial and pulmonary artery pressures following closure of the A.S.D. Although the post-operative systemic hypertension was transient in most cases, it may produce adverse effects in the early post-operative period and therefore treatment with hypotensive agents should be considered in severe cases.