Surgical Treatment of Atrial Septal Defect With Special Reference to Aged Patients

Two hundred and seventy-eight patients were operated on for secundum atrial septal defect (ASD) between 1973 and 1986. Among them, seventeen patients (6%) were over the age of 40 years. The operative mortality was 0.3%. One 53-year-old woman died due to respiratory dysfunction during the postoperative course.Preoperative symptoms, electrocardiographic findings, hemodynamics, and postoperative complications in patients of various age groups were dicussed.Preoperative, half of all patients over the age of 20 years had symptoms of heart failure and arrhythmia.CRBBB, af, RVH and ST-T change apperaed in elderly patients more frequently.Pulmonary arterial pressure tended to be increased slightly in patients over the age of 50 years. left-to-right shunt ratio tended to be increased in elderly patients. It was considered that high pulmonary blood flow was the cause of pulmonary hypertension in most elderly patients with ASD.For the postoperative care of elderly patients with ASD, it was important to reduce arrhythmias by either temporary pacing or the use of anti-arrhythmia drugs.Postoperative improvement of physical activity was obtained even in elderly patients. We consider that it is better for elderly patients with ASD to undergo surgical treatment, except those with either Eisenmenger syndrome or other severe complications.