Surgical closure of atrial septal defects in adults: effect of age at operation on outcome

被引:53
作者
Ghosh, S [1 ]
Chatterjee, S [1 ]
Black, E [1 ]
Firmin, RK [1 ]
机构
[1] Univ Hosp Leicester NHS Trust, Dept Cardiothorac Surg, Glenfield Hosp, Leicester LE3 9QP, Leics, England
关键词
D O I
10.1136/heart.88.5.485
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To determine whether age has an effect on the long term outcome after surgical closure of atrial septal defects in patients aged 35 years and over. Methods: Retrospective analysis of 89 patients (64 women) operated on between 1989 and 1999. Patients were divided into two age groups: group I (aged 35-50 years, n = 51) and group II (>50 years, n = 38). Follow up was between 1-11 years. Results: One operative death and two late deaths occurred in the study period (both in group 11). Preoperatively, 29 (57%) patients were in New York Heart Association functional class III-IV in group I compared with 22 (58%) patients in group II (NS). After operation, 44 (86.2%) patients in group I were found to be in class I-II compared with 25 (71.5%, p < 0.05) in group II. Group I patients had a lower incidence of preoperative atrial fibrillation than those in group 11 (12 (23.5%) v 17 (43.6%), p < 0.05) and only four (7.8%) patients in group I were in atrial fibrillation requiring long term warfarin after surgery compared with 12 (34%, p < 0.05) in group II. Furthermore, echocardiography showed a greater reduction in right ventricular dimension in group I patients (mean (SD) 4.26 (0.82) v 2.71 (0.41) cm, p < 0.001) than in group II patients (4.36 (0.43) v 3.87 (0.29) cm, p = 0.21). No residual intracardiac shunts were identified during follow up. Conclusions: Surgical closure of atrial septal defects in adult patients can improve clinical status and prevent right ventricular dilatation. The greatest benefit is seen in younger patients.
引用
收藏
页码:485 / 487
页数:3
相关论文
共 24 条
[1]  
Bedford DE, 1941, BRIT HEART J, V3, P37
[2]  
CAMPBELL M, 1970, BRIT HEART J, V32, P820
[3]  
CAMPBELL M, 1957, BRIT HEART J, V19, P403
[4]  
Cooley DA, 2000, CIRCULATION, V102, P87
[5]   Comparison of results of closure of secundum atrial septal defect by surgery versus amplatzer septal occluder [J].
Cowley, CG ;
Lloyd, TR ;
Bove, EL ;
Gaffney, D ;
Dietrich, M ;
Rocchini, AP .
AMERICAN JOURNAL OF CARDIOLOGY, 2001, 88 (05) :589-+
[6]   NATURAL HISTORY AND PROGNOSIS OF ATRIAL SEPTAL DEFECT [J].
CRAIG, RJ ;
SELZER, A .
CIRCULATION, 1968, 37 (05) :805-&
[7]  
DICKINSON DF, 1981, BRIT HEART J, V46, P55
[8]  
FELDT RH, 1971, MAYO CLIN PROC, V46, P794
[9]  
Fuster V, 1980, Cardiovasc Clin, V10, P161
[10]   Transcatheter closure of atrial septal defect with a new flexible, self-centering device - (The STARFlex occluder) [J].
Hausdorf, G ;
Kaulitz, R ;
Paul, T ;
Carminati, M ;
Lock, J .
AMERICAN JOURNAL OF CARDIOLOGY, 1999, 84 (09) :1113-+