Surgery of Atrial Septal Defect in Adults over Fifty Years of Age / 日本心臓血管外科学会雑誌

ABSTRACT

During past 4 years, 15 patients over 50 years of age with secundum atrial septal defect underwent surgery in our hospital. The ages ranged from 50 to 70 years with a mean of 59.7 years. Before operation, 8 were in functional class II, 7 in class III (New York Heart Associasion classification). Thirteen patients had pulmonary hypertension, 8 had right-to-left shunt and 6 had atrial fibrillation. Pulmonary function test showed decreased %VC and FEV_1.0% with a mean of 74% and 65%, respectively. Cardiothoracic ratio ranged from 48 to 77 with a meam of 60%. Preoperative laboratory data showed significant inverse correlations between CTR and %VC and between pulmonary arterial pressure and %VC. The defects were closed directly in 6 patients and closed using patches in 9. All patients survived the operation. Postoperatively, antithrombotic agents were administered to the patients with patch closure. After operation, all but one improved to functional class I and no patients had embolic episode.