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Ostium secundum atrial septal defect in the elderly
F Landi1, L Cipriani, A Cocchi
1Department of Geriatrics, Universita Cattolica del Sacro Cuore, Rome, Italy.
Insights
Atrial septal defect (ASD) is a common congenital heart issue. This study highlights rare cases of elderly patients with significant ASDs, emphasizing careful consideration for surgical intervention in older individuals.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Geriatric Medicine
Background:
- Atrial septal defect (ASD) is a prevalent congenital cardiac anomaly.
- Significant ASDs can lead to shortened life expectancy and congestive heart failure.
- Progression to heart failure is linked to pulmonary hypertension, arrhythmias, and other cardiovascular issues.
Observation:
- This report details three unique cases of elderly individuals with substantial ASDs.
- These patients experienced a late onset of symptoms, defying typical disease progression.
- Their advanced age presented unique challenges for potential interventions.
Findings:
- Significant ASDs can remain asymptomatic until advanced age.
- Elderly patients with ASDs present a complex clinical scenario.
- Late diagnosis and intervention in ASD require careful consideration.
Implications:
- The findings suggest a need to reconsider diagnostic and treatment paradigms for ASD in the elderly.
- Surgical closure risks and outcomes in older adults necessitate individualized assessment.
- Further research is warranted to understand long-term management strategies for geriatric ASD patients.
Abstract:
Atrial septal defect (ASD) is one of the most common congenital cardiac anomalies in adults. Life expectancy is shortened, and almost 90% of patients die by the age of 60 years. The progression of this congenital disease to congestive heart failure has been related to several factors such as the onset of pulmonary hypertension, arrhythmias, bronchopulmonary infections, or the development of other cardiovascular disease. We describe three cases of very old patients with significant ASDs and late development of symptoms. Given the higher risks and poorer long-term results of surgical closure of the defect in advanced age, the indications for such an intervention in elderly patients should be carefully evaluated.