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[Artrial septal defect in the adult (author's transl)]
Insights
Ostium secundum defects in adults often present without severe symptoms and allow for normal life expectancy. Surgical closure indications should prioritize patient symptoms over unproven assumptions about long-term benefits.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Adult Congenital Heart Disease
Context:
- Presents clinical and hemodynamic findings in 96 adult patients with ostium secundum defects.
- Investigates relationships between symptom severity, clinical status, and hemodynamic parameters.
Purpose:
- To evaluate the clinical presentation and hemodynamic characteristics of adult ostium secundum defects.
- To inform decision-making regarding surgical intervention for ostium secundum defects in adults.
Summary:
- No clear interrelationships found between symptom extent/clinical state and heart size, shunt volume, or other hemodynamic parameters.
- Congenital cardiac malformation can be associated with normal life expectancy and absence of severe symptoms for decades.
- Uncertainty exists regarding the long-term benefits of surgical closure, including life expectancy prolongation and morbidity reduction.
Impact:
- Highlights the need for clinical status and symptom severity to guide surgical indications for ostium secundum defects.
- Suggests that current surgical indications may rely on unproven assumptions due to limited data on long-term surgical outcomes.
- Emphasizes the potential for a normal life expectancy in adults with untreated ostium secundum defects.
Abstract:
The clinical and hemodynamic findings of 96 adult patients with ostium secundum defect are presented. There are no interrelationships between the extent of symptoms and clinical state on one side and heart size, shuntvolume and other hemodynamic parameters on the other hand. Our observations do not allow firm conclusions as the the natural course of the affection. It can be stated however, that this congenital cardiac malformation can be associated with a normal life exspectancy and without severe symptoms for decades. Hence we see problems as to the indication of the surgical closure of the defect, since not much is known about the longstanding usefulness of surgery in respect to a possible prolongation of life exspectancy and diminuition of morbidity. We therefore are of the opinion that - until such data are available - the indication for surgery should not be guided by prospective nonproved assumption but by the clinical state of the patient and the severity of his symptoms.