[Study of operative cases for atrial septal defect in patients aged more than 50 years--correlation with...

Twenty-nine patients aged 18 years or older underwent radical operation for atrial septal defect between April, 1987 and March, 1992 at the First Department of Surgery, Hiroshima University School of Medicine. They were divided into two groups: Group-I consisted of 18 patients who were less than 49 years old, and group-II who were more than 50 years old. The two groups were compared with respect to the following: 1. sex, 2. symptoms, 3. chest X-ray (CTR), 4. renal function (BUN, Cr), 5. lung function (vital capacity, % forced expiratory volume in one second), 6. echocardiographic examination of MVP, MR, and TR, cardiac catheterization data (left-to-right shunt ratio, Qp/Qs, pulmonary artery pressure), 8. septal defect size and surgical method, and 9. postoperative arrhythmia. The following results were obtained in group-II as compared with group-I: 1. the ratio of women was higher (82% vs. 61%), 2. the ratio of symptoms was higher (82% vs. 44%), 3. cardiomegaly was more severe on chest X-ray (CTR 58 +/- 5% vs. 50 +/- 5%), 4. septal defect size was larger (4.9 +/- 2.1 cm2 vs. 3.3 +/- 1.6 cm2), 5. vital capacity was lower (91 +/- 14% vs. 105 +/- 14%), and 6. the incidence of postoperative transient arrhythmia was higher (55% vs. 6%). Group-II was subsequentry divided into two subgroups: 7 patients not using digitalis and furosemide, and 4 patients who did use digitalis and furosemide prophylactically. The incidence of postoperative arrhythmia was compared between the two subgroups.(ABSTRACT TRUNCATED AT 250 WORDS)