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Closure of secundum atrial septal defect in adults
Maqsood M Elahi1, Philip R Belcher, James C S Pollock
1Department of Cardiothoracic Surgery, Royal Infirmary, Glasgow G31 2ER, UK. manzoor_elahi@hotmail.com
Objective:
To examine the outcome of ASD closure in adults and the effect of patient's age on drug therapy, symptoms and incidence of atrial fibrillation.
Design:
A follow-up study.
Place And Duration Of Study:
University Department of Cardiothoracic Surgery, Glasgow Royal Infirmary, Glasgow, G31 2ER during the period 1989-1999. SUBJECTS AND METHODS Follow-up analysis of 61 adult patients (39 women) operated between 1989 and 1999 for the repair of secundum atrial septal defects.
Results:
There were no deaths. Five patients from early in the series were lost to follow-up. Large defect size was associated with patch rather than direct closure but there was extensive crossover. Analysis by age showed that patients over 49 had more postoperative atrial fibrillation (P=0.001), more chest pain (P< 0.0001), more postoperative dyspnea (p=0.021), greater use of diuretics (p=0.020) and longer hospital stay (10.1 + 2.6 vs 8.5 + 1.6 days; p=0.007) than patients under 49.
Conclusion:
Operation for atrial septal defects in adults can be performed with no mortality and low morbidity. The age at which complications appear more frequent suggests that closer analysis of these patients is required.