open access

Vol 64, No 5 (2006)
Other
Published online: 2006-06-01
Submitted: 2012-12-28
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Original article
Atrial septal defect in adults: the influence of age and haemodynamic parameters on the results of surgical repair

Elżbieta Suchoń, Wiesława Tracz, Piotr Podolec, Jerzy Sadowski
Kardiol Pol 2006;64(5):470-476.

open access

Vol 64, No 5 (2006)
Other
Published online: 2006-06-01
Submitted: 2012-12-28

Abstract

Introduction: Indications for closure of atrial septal defect (ASD) are well established in children but still unclear in adult patients. There is also a discrepancy regarding the natural history of the defect and benefits of ASD closure and long-term prognosis. Aim: The aim of the study was to evaluate the outcome of surgical closure of atrial septal defect (ASD) with respect to age and selected haemodynamic parameters. Methods: The study involved 52 patients with ASD, aged 38.6±15 years. All patients had a clinical examination, echocardiography, Holter ECG monitoring and cardiopulmonary exercise test (CPX) prior to and at least one year after the surgery. The results were analysed for the entire group of patients and then for the following subgroups of pts.: aged <40 and ł40 years; with right ventricular systolic blood pressure (RVSP) £30 and >30 mmHg; and with shunt volume ratio (Qp/Qs) <2.5 and ł2.5. Results: After repair of ASD, a significant improvement of the clinical status, as defined by NYHA class, was observed. At the same time, a constant or even increased incidence of arrhythmias was found. Repair of the defect resulted in a significant reduction of the right ventricular diameters in all studied subgroups. Among all evaluated parameters, only age at time of the operation was significantly associated with right ventricular diameter after surgery (b=0.598; p <0.001). Exercise capacity was found to have significantly increased after surgery, regardless of age, RVSP and Qp/Qs, but it remained significantly reduced in patients with pulmonary arterial hypertension compared to subjects with normal RVSP before ASD repair. A significant correlation was shown between peak oxygen consumption and RVSP both before (r=–0.68; p <0.001) and after (r=–0.38; p=0.01) surgery. Conclusions: Patients benefit from surgical closure of ASD regardless of age and previous RVSP and Qp/Qs. Age at the time of surgery and pulmonary arterial pressure determine long-term results and improvement of echocardiographic and ETT parameters.

Abstract

Introduction: Indications for closure of atrial septal defect (ASD) are well established in children but still unclear in adult patients. There is also a discrepancy regarding the natural history of the defect and benefits of ASD closure and long-term prognosis. Aim: The aim of the study was to evaluate the outcome of surgical closure of atrial septal defect (ASD) with respect to age and selected haemodynamic parameters. Methods: The study involved 52 patients with ASD, aged 38.6±15 years. All patients had a clinical examination, echocardiography, Holter ECG monitoring and cardiopulmonary exercise test (CPX) prior to and at least one year after the surgery. The results were analysed for the entire group of patients and then for the following subgroups of pts.: aged <40 and ł40 years; with right ventricular systolic blood pressure (RVSP) £30 and >30 mmHg; and with shunt volume ratio (Qp/Qs) <2.5 and ł2.5. Results: After repair of ASD, a significant improvement of the clinical status, as defined by NYHA class, was observed. At the same time, a constant or even increased incidence of arrhythmias was found. Repair of the defect resulted in a significant reduction of the right ventricular diameters in all studied subgroups. Among all evaluated parameters, only age at time of the operation was significantly associated with right ventricular diameter after surgery (b=0.598; p <0.001). Exercise capacity was found to have significantly increased after surgery, regardless of age, RVSP and Qp/Qs, but it remained significantly reduced in patients with pulmonary arterial hypertension compared to subjects with normal RVSP before ASD repair. A significant correlation was shown between peak oxygen consumption and RVSP both before (r=–0.68; p <0.001) and after (r=–0.38; p=0.01) surgery. Conclusions: Patients benefit from surgical closure of ASD regardless of age and previous RVSP and Qp/Qs. Age at the time of surgery and pulmonary arterial pressure determine long-term results and improvement of echocardiographic and ETT parameters.
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Keywords

atrial septal defect; surgical repair; age

About this article
Title

Original article
Atrial septal defect in adults: the influence of age and haemodynamic parameters on the results of surgical repair

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 64, No 5 (2006)

Pages

470-476

Published online

2006-06-01

Bibliographic record

Kardiol Pol 2006;64(5):470-476.

Keywords

atrial septal defect
surgical repair
age

Authors

Elżbieta Suchoń
Wiesława Tracz
Piotr Podolec
Jerzy Sadowski

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