What does this research mean for the field?

Repair of secundum atrial septal defects in adults over 40 yields good long-term outcomes for patients with mild preoperative symptoms or normal sinus rhythm, but does not reverse existing or prevent new-onset atrial fibrillation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

November 1, 1978

Late Results of Atrial Septal Defect Repair in Adults

Structured PICO

Does repair of secundum atrial septal defects improve long-term outcomes in patients older than 40 years?

Population

75 patients older than age 40 years with secundum atrial septal defects

Intervention

Repair of secundum atrial septal defects

Outcome

Long-term result (prognosis) and atrial fibrillation status

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.

Abstract

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.

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