Atrial septal defect in patients ages 60 years or older: operative results and long-term postoperative follow-up.

Sutton, Micjae; Tajik, A. Jamil; McGoon, Dwight C.

doi:10.1161/01.cir.64.2.402

Cited by 174 publications

(71 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…18 Despite the improvement in symptoms, patients in the present study who had repair after age 40 years demonstrated persistent dyspnea on exertion, possibly due to accelerated late diastolic dysfunction; the dyspnea was more pronounced than in patients younger than 40 years. This finding underscores the importance of early surgical intervention.…”

Section: Postoperative Symptoms and Long-term Follow-upcontrasting

confidence: 56%

Sinus Venosus Atrial Septal Defect

et al. 2005

View full text Add to dashboard Cite

Background— Sinus venosus atrial septal defect (SVASD) differs from secundum atrial septal defect by its atrial septal location and its association with anomalous pulmonary venous connection (APVC). Data on long-term outcome after surgical repair are limited. Methods and Results— We reviewed outcomes of 115 patients (mean age±SD 34±23 years) with SVASD who had repair from 1972 through 1996. APVC was present in 112 patients (97%). Early mortality was 0.9%. Complete follow-up was obtained for 108 patients (95%) at 144±99 months. Symptomatic improvement was noted in 83 patients (77%), and deterioration was noted in 17 patients (16%). At follow-up, 7 (6%) of 108 patients had sinus node dysfunction, a permanent pacemaker, or both, and 15 (14%) of 108 patients had atrial fibrillation. Older age at repair was predictive of postoperative atrial fibrillation ( P =0.033). No reoperations were required during follow-up. Survival was not different from expected for an age- and sex-matched population. Clinical improvement was more common with older age at surgery ( P =0.014). Older age at repair ( P =0.008) and preoperative New York Heart Association class III or IV ( P =0.038) were independent predictors of late mortality. Conclusions— Operation for SVASD is associated with low morbidity and mortality, and postoperative subjective clinical improvement occurs irrespective of age at surgery. Postoperative atrial fibrillation appears to be related to older age at operation. SVASD repair achieves survival similar to that of a matched population and should be considered whenever repair may impact survival or symptoms.

show abstract

Section: Postoperative Symptoms and Long-term Follow-upcontrasting

confidence: 56%

Sinus Venosus Atrial Septal Defect

et al. 2005

View full text Add to dashboard Cite

show abstract

“…9,38 In the Mayo Clinic series, the prevalence of late atrial flutter or fibrillation rose progressively with mean age at surgery above 11 years, 22 whereas in another series of ASD patients aged Ն60 years, arrhythmia prevalence was 52%. 39 In our surgical series from Toronto, the preoperative and postoperative risks of atrial flutter or fibrillation were closely related to patient age above or below 40 years 11 ( Figure 6). In contrast, atrial flutter and fibrillation and sick sinus syndrome are very uncommon among patients who underwent ASD closure during childhood or early adulthood, even after long-term follow-up.…”

Section: Arrhythmiamentioning

confidence: 87%

Atrial Septal Defects in the Adult

2006

View full text Add to dashboard Cite

“…Under these circumstances prognosis is excellent, especially if repair is performed earlier in life (eg, <25 years of age). 66 Repair later in life is associated with symptomatic improvement and possibly improved prognosis, 63,67 but may not obviate the increased risk of premature death. 66 A subset of patients may also have subclinical residual right heart and pulmonary vascular dysfunction that limits RV stroke volume augmentation during exercise after ASD closure.…”

Section: Identifying Patients Who Would Benefit From Asd Closurementioning

confidence: 99%

Clinical Evaluation and Management of Pulmonary Hypertension in the Adult With Congenital Heart Disease

Opotowsky

2015

Circulation

View full text Add to dashboard Cite

200P ulmonary hypertension (PH) refers to elevated pulmonary artery (PA) pressure (PAP), defined as mean PAP≥25 mm Hg. PH is not synonymous with pulmonary arterial hypertension (PAH), which specifies resistive PH characterized by elevated pulmonary vascular resistance (PVR) and normal pulmonary venous pressure. Approximately 5% to 10% of adults with congenital heart disease (CHD) have PH, and this subset of CHD patients is at higher risk of hospitalization and death. [1][2][3] Understanding the epidemiology of PH associated with CHD (PH-CHD) is not straightforward, however, because definitions of PH-CHD and diagnostic techniques vary. Appropriate diagnosis and the management of PH-CHD rest on identifying the cause of elevated PAP: high pulmonary venous pressure, high pulmonary vascular resistance, high pulmonary flow, or some combination of these factors, which are referred to throughout this review as passive, resistive, hyperkinetic, and polygenic PH, respectively (Table 1).Prognosis in PH-CHD depends on the underlying cause, pulmonary vascular pathophysiology, and the interaction between the right heart and pulmonary circulation. Adult CHD is heterogeneous, with myriad permutations of underlying defects, previous interventions, and associated comorbidities. Although comprehensive understanding of clinical context is a prerequisite, identifying the optimal therapy for a patient with PH-CHD depends more heavily on an understanding of pathophysiology than it does on the underlying diagnosis. Therefore, the goal of this review is to frame an understanding of PH-CHD in terms of fundamental cardiopulmonary hemodynamic pathophysiology and to emphasize the clinical assessment and management of situations commonly encountered by adult cardiologists caring for patients with PH-CHD. Classifications of PH and PH-CHDClassification schemes in PH represent clinical perspectives of underlying pathophysiology and tend to parallel fundamental hemodynamic relationships of the pulmonary circulation. PVR

show abstract

Atrial septal defect in patients ages 60 years or older: operative results and long-term postoperative follow-up.

Cited by 174 publications

References 21 publications

Sinus Venosus Atrial Septal Defect

Sinus Venosus Atrial Septal Defect

Atrial Septal Defects in the Adult

Clinical Evaluation and Management of Pulmonary Hypertension in the Adult With Congenital Heart Disease

Contact Info

Product

Resources

About