Surgical Closer of Atrial Septal Defect in Adults after 40 Years Old

Objective: Atrial septal defect (ASD) is the most common congenital heart disease in adults. The aim of this study was to determine the value of surgical closure of ASD in patients over 40 years of age. Materials and Methods: Retrospective analysis of 96 patients with the mean age of 47.58 ± 6.59, who had undergone surgical repair of ASD, was carried out. Pre and postoperative clinical status, New York Heart Association (NYHA) functional class and systolic pulmonary artery pressure before and after surgical repair, complications of post operation were assessed and analyzed. The follow-up period was between 1 month and 16 years. Results: Before the operations, 62 patients (89.8%) were placed in NYHA functional classes of II and III. However, after the surgeries most of the patients could be placed in the functional classes I and II. The mean of pulmonary artery pressure before the surgeries was about 46.68 ± 14.18 and dropped to 32 ± 11.89 mm Hg after the operations (P < 0.0001). Atrial fibrillation rhythm was present in 18 cases preoperatively which was reduced to 3 patients at the discharge time (16.6%). The mean right ventricular (RV) sizes were reduced from 4.1 to 2.5 cm after the surgical repairs. In 35 cases (36.64%), we had no tricuspid valve regurgitation after surgery for RV systolic presser estimation. Conclusion: Surgical closure of ASD in patients over 40 years of age could improve their clinical status, and lead to a reduced pulmonary systolic as well as smaller RV sizes.