Surgical Correction of Atrial Septal Defect in Adult

성인 심방중격결손증의 수술교정

  • Published : 1995.09.01

Abstract

Repairs of atrial septal defect utilizing cardiopulmonary bypass were performed in 50 adults, ranging age from 16 to 53 years, since April 1986 up to October 1994. They occupied 38.8% of all adult congenital heart disease operated in the same period. Preoperatively, 16 patients were functional class II, 12 patients class III and 4 patients class IV[New York Heart Association Classification , respectively. Five patients combined with atrial fibrillation and the remainders revealed regular sinus rhythm. Cardiac catheterizations were performed in 43 out of 50 patients, and revealed a systolic pulmonary arterial pressure in excess of 51 mmHg in 4 patients but none had reversed shunt. 40 patients[80% were repaired with patch closure and remainings were repaired with direct closure. 49 patients were followed up for 2 months up to 102 months[average 55 months . A comparison of the preoperative and postoperative functional class demonstrated a mean decrease of one NYHA functional level[2.5$\pm$0.63 to 1.4$\pm$0.56 . There was no operative mortality. One patient died during the follow-up period and the death was unrelated to heart disease. Operative treatment is indicated for repair of atrial septal defect with left to right shunt in the adult patient and a considerable clinical improvement can be anticipitated with low mortality.

Keywords

References

  1. Am. J. Cardiol. v.17 Congenital cardiovascular anomalies in adults;Results of surgical treatment in 167 patients over the age 35 Cooley,D.A.;Hallman,G.I.;Hamman,A.S.
  2. Br. Heart J. v.32 Natural history of atrial septal defect Campbell,M.
  3. Circulation v.37 Natural history and prognosis of atrial septal defect Craig,R.J.;Selzer,A.
  4. Br. Heart J. v.30 Atrial septal defect in patients over 45 years of age;Merits of surgical versus medical therapy Wolf,P.S.;Vogel,J.H.K.;Pryor,R.;Blount,S.G.
  5. JAMA v.200 Life expectancy with atrial septal defect;Influence of complicating pulmonary vascular disease Dalen,J.E.;Haynes,F.W.;Dexter,L.
  6. Am. Heart J. v.94 Atrial septal defect of secundum type in the middle-aged Forfang,K.;Simonsen,S.;Anderson,A.;Efskind,L.
  7. 대흉외지 v.25 성인의 선천성 심질환 정신현;조광현;황윤호(등)
  8. 대흉외지 v.13 성인의 선천성 심장질환의 외과적교정 김광호;김은기;조범구;홍승록
  9. Am. J. Cardiol. v.53 Ostium secundum atrial septal defect-Survival for 87 and 94 years Perloff,J.K.
  10. Arch. Intern. Med. v.121 Atrial fibrillation in atrial septal defect Tikoff,G.;Schmidt,A.M.;Hecht,H.H.
  11. Am. J. Cardiol. v.12 Natural history of atrial septal defect with criteria for selection for surgey Mark,H.
  12. Circulation v.35;36 no.SUP. Ⅰ Results of operation for atrial septal defect in patients forty-five years of age and older Daicoff,G.R.;Brandenburg,R.O.;Kirklin,J.W.
  13. Circulation v.64 Atrial septal defect in patients ages 60 years or older;Operative results and long-term postoperative follow-up St.John Sutton,M.G.;Tajik,A.J.;McGoon,D.C.
  14. Circulation v.19 Atrial septal defect : Factors affecting the surgical mortality rate McGoon,D.C.;Swan,H.J.C.;Brandenburg,R.O.;Connoly,D.C.;Kirklin,J.W.
  15. Circulation v.37 Atrial septal defect in patients over the age of forty years Gault,J.H.;Morrow,A.G.;Gay,W.A.;Ross,J.
  16. Circulation v.76 Isolated atrial septal defect with pulmonary vascular obstructive disease-Long-term follow-up and prediction of outcome after surgical correction Steele,P.M.;Fuster,V.;Cohen,M.;Ritter,D.G.;McGoon,D.C.
  17. Am. J. Cardiol. v.31 Atrial septal defect in adults;Clinical and hemodynamic results of surgery Dave,K.S.;Pakrashi,B.C.;Wooler,G.H.;Ionescu,M.I.
  18. Arch. Surg. v.123 Surgical closure of atrial septal defect in patinents older than 50 years of age Fiore,A.C.;Naunheim,K.S.;Kessler,K.A.(et al.)
  19. Circulation v.39;40 no.SUP. Ⅰ Embolic complications following repair of atrial septal defects Hawe,A.;Rastelli,G.C.;Braundenburg,R.O.;McGoon,D.G.
  20. N. Engl. J. Med. v.323 The effect of low-dose warfarin on the risk of stroke in patients with nonrheumatic atrial fibrillation The Boston Area Anticoagulation Trial for Atrial Fibrillation Investigators