A Comparison of Surgical and Medical Therapy for Atrial Septal Defect in Adults
Why the study?
Does surgical repair reduce mortality from all causes in patients over 40 years of age with isolated atrial septal defects compared to medical therapy?
Population
179 consecutive patients with isolated atrial septal defects diagnosed after the age of 40
Comparison
Surgical repair of atrial septal defect vs Medical therapy
Design
Cohort
Follow-up
mean 8.9 +/- 5.2 years (range, 1 to 26)
Authors
Discussion
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Implication
May support surgical closure to reduce mortality in adults over 40 with ASD; extends observational data but leaves open need for randomized confirmation.
Key Points
- This study aims to compare the long-term outcomes of surgical closure versus medical therapy for atrial septal defects in adults over 40.
- Retrospective analysis of 179 patients diagnosed with atrial septal defect after age 40.
- Compared outcomes of 84 patients who underwent surgical repair to 95 who received medical treatment.
- Mean follow-up period was 8.9 years.
- Surgical repair significantly reduced overall mortality (relative risk, 0.31; 95% CI, 0.11 to 0.85).
- 10-year survival rate for surgically treated patients was 95%, compared to 84% for medically treated patients.
- Surgical treatment prevented functional deterioration (relative risk, 0.21; 95% CI, 0.08 to 0.55).
Structured PICO
Does surgical repair reduce mortality from all causes in patients over 40 years of age with isolated atrial septal defects compared to medical therapy?
P
Population
179 consecutive patients with isolated atrial septal defects diagnosed after the age of 40
I
Intervention
Surgical repair of atrial septal defect
C
Comparator
Medical therapy
O
Outcome
Mortality from all causeshard clinical
In adults over 40 with isolated atrial septal defects, surgical repair significantly reduces all-cause mortality and functional deterioration compared to medical therapy.
Cite This Study
Konstantinides et al. (1995) studied this question.