Does repair of secundum atrial septal defects improve long-term outcomes in patients older than 40 years?
Repair of secundum atrial septal defects in adults over 40 yields good long-term results, particularly in those with lower functional class and normal sinus rhythm, but does not reverse or prevent atrial fibrillation.
Repair of secundum atrial septal defects in 75 patients older than age 40 years was associated with a good long-term result, from five to 21 years postoperatively, in 89% of patients who were class I and II preoperatively and in 86% of those in normal sinus rhythm preoperatively. Functional class III or IV, atrial fibrillation, a higher pulmonary artery mean pressure and higher pulmonary vascular resistance affected the prognosis adversely. Repair of atrial septal defect in adults did not reverse existing atrial fibrillation and did not protect against the onset of new atrial fibrillation.
Donald J. Magilligan (Wed,) studied this question.
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