Secundum type atrial septal defect in adult patients: operative results and mid-term follow-up

Background: Secundum type atrial septal defect is the most commonly congenital heart disease which has been detected in adults . It is relatively common to observe atrial fibrillation in these patients after the age of fourty. Our study includes the midterm follow-up results of patients who were operated due to secundum type ASD. Methods: 52 adult patients were operated in our clinic between January 2001 and December 2007 due to secundum type atrial septal defect. Mean age was 35.63±12.4 (range 18-60 years) where 37 (71.2%) were female and, 15 (28.8%) were male. The patients were grouped into two with respect to age: Group I included patients aged between 18-40 and Group II included those between 40-60 years of age. 11 patients presented preoperative atrial fibrillation (21.1%). Preoperative mean pulmonary /systemic flow ratio was 2.39 ± 0.59 and mean pulmonary artery pressure was 36.80±9.48. Before the operation 36 patients were in New York Heart Association functional class II (69.2 %), 13 were in class III (25%) and three was in class I (5.8%). Results: Preoperative atrial fibrillation converted to sinus rhythm in 4 of 11 patients in the postoperative period. Postoperative atrial fibrillation continued in five patients in the follow-up period despite the medical treatment. In the follow up period 42 patients were in New York Heart Association functional class I (80.8%) and 10 were in class II (19.2%). Mean follow up period was 36.67±23.12 months. No mortality was observed neither in intraoperative nor in the post operative or follow-up periods. Conclusion: Surgical closure of secundum type atrial septal defect in adult patients and antiarrhytmic therapy in those with atrial fibrillation is a effective method in decreasing morbidity and mortality rates.