S Ghosh1, S Chatterjee, E Black, R K Firmin. 1. Department of Cardiothoracic Surgery, University Hospitals Leicester NHS Trust, Glenfield Hospital, Leicester, UK. sudip.ghosh@uhl-tr.nhs.uk
Abstract
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 II). 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 II (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.
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 II). 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 II (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.
Authors: J G Murphy; B J Gersh; M D McGoon; D D Mair; C J Porter; D M Ilstrup; D C McGoon; F J Puga; J W Kirklin; G K Danielson Journal: N Engl J Med Date: 1990-12-13 Impact factor: 91.245
Authors: G Santoro; M Pascotto; S Caputo; F Cerrato; M Cappelli Bigazzi; M T Palladino; C Iacono; M Carrozza; M G Russo; R Calabrò Journal: Heart Date: 2005-12-09 Impact factor: 5.994