[Surgical treatment of residual defects following closure of secundum atrial septal defect]
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Recurrent secundum atrial septal defects occurred in 7 of 1485 patients after surgical repair. Reoperation confirmed residual defects, with no mortality and manageable complications, highlighting the need for careful diagnosis and treatment.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease
Context:
- Secundum atrial septal defect (ASD) is a common congenital heart defect.
- Surgical repair is the standard treatment for secundum ASD.
- Long-term outcomes and recurrence rates require ongoing investigation.
Purpose:
- To analyze the incidence and characteristics of symptomatic recurrence of secundum ASD after surgical repair.
- To investigate the causes, diagnostic methods, treatment strategies, and prognosis of residual defects.
- To evaluate the safety and efficacy of reoperation for recurrent secundum ASD.
Summary:
- Seven out of 1485 patients (0.47%) experienced symptomatic recurrence of secundum ASD after initial surgical repair between 1958 and 1986.
- All recurrent cases presented with persistent systolic murmurs and confirmed residual defects via right heart catheterization.
- Reoperation under cardiopulmonary bypass was performed with no early or late mortality, and low rates of major complications such as hemothorax and temporary atrial fibrillation.
Impact:
- This study underscores the importance of vigilant follow-up for patients undergoing secundum ASD repair.
- It provides valuable insights into the management of residual defects, emphasizing reoperation as a safe and effective option.
- The findings contribute to the understanding of long-term outcomes in secundum ASD management and inform clinical decision-making.
Abstract:
Among 1485 patients with secundum atrial septal defect repaired from May, 1958 through May, 1986, 6 and 1 additional patient were readmitted to our hospital with symptomatic recurrence. In all but 1, their systolic murmur persisted. Cardiothoracic ratio and pulmonary plethora remained unaltered. A residual defect in all of the 7 patients was confirmed by right heart catheterization. They were reoperated upon under cardiopulmonary bypass. There was no early mortality, nor late death. The major postoperative complications include: hemothorax in 2 cases; temporary atrial fibrillation in 1. This article analysis the common causes of residual defect and discussed methods of diagnosis, treatment and prognosis.