Mid- to Long-term Results of Surgical Treatment of ASD in Patients over 60 Years Old

Jeong, In-Seok; Ahn, Byoung-Hee; Soonjin, Kim; Oh, Sang-Gi; Oh, Bong-Suk; Kim, Sang-Hyung

doi:10.5090/kjtcs.2011.44.2.137

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…In contrast, Jeong et al found much higher mortalities of 21% after closure and 27% with no closure with a mean follow-up of 6.8 years. 24 John Sutton et al 4 found that adult patients with ASD closure did not have altered survival compared with a matched control group 5–10 years after closure. The very low long-term survival of 40% in patients with closure found by Murphy et al 1 was not replicated in this study.…”

Section: Discussionmentioning

confidence: 99%

Long-term mortality in patients with atrial septal defect: a nationwide cohort-study

Nyboe

Karunanithi

Nielsen‐Kudsk

et al. 2017

European Heart Journal

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AimsIn this nationwide cohort of atrial septal defect (ASD) patients, the largest to date, we report the longest follow-up time with and without closure in childhood and adulthood compared with a general population cohort.Methods and resultsUsing population-based registries, we included Danish individuals born before 1994 who received an ASD diagnosis between 1959 and 2013. All diagnoses were subsequently validated (n = 2277). Using the Kaplan–Meier estimates and Cox proportional hazards regression adjusted for sex, birth year, and a modified Charlson Comorbidity Index, we compared the mortality of ASD patients with that of a birth year and sex matched general population cohort. The median follow-up from ASD diagnosis was 18.1 years (range 1–53 years). Patients with ASD had a higher mortality [adjusted hazard ratio (HR): 1.7; 95% confidence interval (CI): 1.5–1.9] compared with the general population cohort. The adjusted HR 30 days after closure was 1.4 (95% CI: 1.2–1.7), and it was 2.4 (95% CI: 2.0–2.9) for patients without closure.ConclusionOverall, ASD patients had a higher long-term mortality than a general population cohort matched on birth year and gender. Our data indicate a lower relative mortality of those ASD patients undergoing closure than the ASD patients not undergoing closure.

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Section: Discussionmentioning

confidence: 99%

Long-term mortality in patients with atrial septal defect: a nationwide cohort-study

Nyboe

Karunanithi

Nielsen‐Kudsk

et al. 2017

European Heart Journal

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“…Kutty et al 16 showed a mortality rate of 3% at the end of follow-up ranged from 5 to 20years. Jeong et al 17 found a much higher mortalities of 21% after closure and 27% mortality in patients with no closure, with a mean follow-up of 6.8years. John Sutton et al 18 revealed that adult patients with ASD closure did not have altered survival compared with a matched control group 5 to 10years after closing.…”

Section: Discussionmentioning

confidence: 98%

Long-term outcome of atrial septal defect (ASD) repair by the figulla flex II ASD occluder: A retrospective cohort study at a referral heart center in Iran

Firouzi¹,

Siraj²,

Jafari³

et al. 2020

JCCR

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Background: By developing the third generation of occluders such as the Figulla Flex II ASD occluder for Atrial Septal Defect (ASD) repairing, the risk of post-procedural adverse events has been significantly reduced. We evaluated the long-term results of ASD device closure using the Figulla Flex II ASD occluder in a tertiary heart center in Iran to assess the brief consequences of the device and procedure.Methods: Three hundred and sixty-five patients undergoing Figulla Flex II ASD occluder insertion for ASD repair at Shahid Rajaee Cardiovascular Medical and Research Center in Tehran reviewed retrospectively. The patients were followed for a mean time of 31.7months (ranged 12 to 51months) to assess the long-term outcome and the patients' complicationfree survival. Results:The most common post-procedure complications within the follow-up time included cardiac arrhythmia [Premature Ventricular Contraction (PVC) in 18 patients and Paroxysmal Supraventricular Tachycardia (PSVT) in 5 patients], erosion in 2 patients and clot on device in 2 patients. The patients' functional status significantly improved after ASD device closure. The overall Major Adverse Cardiac Event (MACE) rate was indicated to be 4.9%. Among baseline variables, the size of ASD and the size of the device could effectively predict the likelihood of long-term MACE. According to the survival analysis, 1, 2, and 3-year free-MACE survival rates were 99.7%, 99.1%, and 90.6%, respectively. Conclusion:ASD repair by the Figulla Flex II ASD occluder leads to a favorable long-term outcome with a three-year free MACE survival rate of more than 90%. This proper outcome may be adversely affected by a large ASD size.

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Clinical outcomes of early closure versus conservative strategy after diagnosis with atrial septal defect: a nationwide population-based cohort study

Min

Lee

Park

et al. 2022

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES The long-term clinical benefits of atrial septal defect (ASD) closure remain controversial. We aimed to compare long-term clinical outcomes between patients who underwent early surgical closure after ASD diagnosis and those who did not. METHODS Using the Korean National Health Insurance Service database, we identified patients with isolated ASDs diagnosed between 1 January 2003 and 31 December 2006. The ASD patients who underwent closure surgery within 6 months after diagnosis were allocated to the early-closure group and the rest were allocated to the conservative-strategy group. The primary outcome was all-cause mortality. Secondary outcomes were atrial flutter/fibrillation (AFF) and ischaemic stroke. RESULTS Among patients without a history of AFF or stroke, 1644 patients in the early-closure group were propensity score matched to 1644 patients in the conservative-strategy group and their median follow-up durations were 12.9 and 12.8 years, respectively. The early closure was associated with a significantly lower risk of mortality (hazard ratio, 0.55 [95% confidence interval, 0.43–0.70]). In an age-stratified analysis, significant mortality reductions in the early-closure group were found in patients aged 40 years or older. The risk of AFF was significantly higher in the early-closure group, which might be mainly ascribed to postoperative transient AFF, while there was no difference in ischaemic stroke between the 2 groups. CONCLUSIONS Our data suggest that timely ASD closure without delay is necessary for ASD patients without previous history of clinical events, especially in patients aged 40 years or older.

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Mid- to Long-term Results of Surgical Treatment of ASD in Patients over 60 Years Old

Cited by 4 publications

References 16 publications

Long-term mortality in patients with atrial septal defect: a nationwide cohort-study

Long-term mortality in patients with atrial septal defect: a nationwide cohort-study

Long-term outcome of atrial septal defect (ASD) repair by the figulla flex II ASD occluder: A retrospective cohort study at a referral heart center in Iran

Clinical outcomes of early closure versus conservative strategy after diagnosis with atrial septal defect: a nationwide population-based cohort study

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