Atrial septal defect in patients over the age of 50

Area of Science:

• Cardiology
• Adult Congenital Heart Disease

Background:

• Atrial septal defects (ASDs) are congenital heart conditions often diagnosed in childhood.
• Late presentation of ASDs in adulthood, particularly in older populations, is less common and may be associated with increased comorbidities.
• Understanding the clinical implications and outcomes of surgical intervention in elderly patients with ASDs is crucial for appropriate management.

Purpose of the Study:

• To evaluate the clinical presentation, haemodynamic status, and long-term follow-up of elderly patients (50-79 years) with atrial septal defects.
• To assess the efficacy and safety of surgical closure in this specific patient cohort.
• To determine the optimal age threshold for surgical intervention in patients with atrial septal defects.

Main Methods:

• Retrospective analysis of clinical, haemodynamic, and follow-up data.
• Inclusion of 49 patients with atrial septal defects presenting between 50 and 79 years of age.
• Assessment of outcomes including arrhythmias, pulmonary vascular disease, heart failure, and surgical mortality.

Main Results:

• Incidence of supraventricular arrhythmias, pulmonary vascular disease, and heart failure increased with age.
• Symptomatic improvement was observed in almost all patients who underwent surgical closure.
• Combined early and late surgical mortality was 6.6%.

Conclusions:

• Surgical closure of atrial septal defects is beneficial for symptomatic patients younger than 70 years.
• In patients aged 70 and above, a cautious approach to recommending surgical closure is advised due to potential risks and limited data.
• Elderly patients with atrial septal defects present with age-related complications, necessitating careful consideration of surgical intervention benefits versus risks.