What does this research mean for the field?

Surgical closure of atrial septal defects in patients over 50 years of age is safe, significantly improves functional status, and yields excellent long-term survival, though primary closure without a patch should be avoided due to the risk of septal dehiscence. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The aim is to evaluate the safety and outcomes of atrial septal defect closure in patients over 50 years old.

August 1, 1988Archives of Surgery

Surgical Closure of Atrial Septal Defect in Patients Older Than 50 Years of Age

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Why the study?

Does operative closure of atrial septal defect improve symptoms and survival in patients older than 50 years?

Key Points

The aim is to evaluate the safety and outcomes of atrial septal defect closure in patients over 50 years old.
Operative closure performed on 51 patients aged 50+ from 1962 to 1986
Follow-up duration ranged from 0.5 to 25 years, with a mean of 9.6 years
Operative techniques included patch closure and primary closure for the defect.
No operative deaths occurred in the series.
Atrial septal defect closure resulted in improved New York Heart Association classification from 2.40 to 1.21 (p<0.01).
Actuarial survival rates were 93%, 86%, and 79% at 5, 10, and 15 years, respectively.

Structured PICO

Does operative closure of atrial septal defect improve symptoms and survival in patients older than 50 years?

Population

51 patients 50 years of age or older (mean, 59.7 years; range, 50 to 77 years) undergoing operative closure of atrial septal defect

Intervention

Operative closure of atrial septal defect (patch closure with pericardium or Dacron in 70%, primary closure in 30%)

Outcome

Operative mortality, long-term survival, NYHA class improvement, and complications (septal dehiscence, emboli)hard clinical

Surgical closure of atrial septal defect in patients over 50 is safe and provides significant symptomatic improvement and excellent long-term survival, particularly when patch closure is used.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Supports ASD closure consideration for symptom relief in patients >50; leaves open randomized confirmation of benefit.

Cite This Study

Andrew C. Fiore (1988) studied this question.

synapsesocial.com/papers/6a1bc07f4ebd09f3dfa8f063 https://doi.org/10.1001/archsurg.1988.01400320051010

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Surgical Closure of Atrial Septal Defect in Patients Older Than 50 Years of Age

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Surgical Closure of Atrial Septal Defect in Patients Older Than 50 Years of Age

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider