PMID- 9191490
OWN - NLM
STAT- MEDLINE
DCOM- 19970707
LR  - 20080409
IS  - 0828-282X (Print)
IS  - 0828-282X (Linking)
VI  - 12
IP  - 10
DP  - 1996 Oct
TI  - Atrial septal defect in adults.
PG  - 983-8
AB  - BACKGROUND: The value of operation of atrial septal defect (ASD) in adults, 
      especially after 40 years, is still discussed. METHODS AND RESULTS: In 1994-95 57 
      adults with unoperated ASD were examined clinically, echocardiographically and in 
      75% by catheterization. Type primum was present in 11%, type secundum in 77% and 
      sinus venosus in 11%. Group A comprised 28 patients aged 20 to 40 years (average 
      29), group B comprised 29 patients aged 40 to 62 years (average 51). The groups 
      (B:A) did not differ in pulmonary to systemic flow (Qp/Qs) (2.4:2.2) or pulmonary 
      arteriolar resistance (PAR) (group B 2 U.m2, group A 1.7 U.m2), the older 
      patients had worse New York Heart Association (NYHA) classification, more 
      frequent tricuspid regurgitation (group B 96%, group A 45%), significantly larger 
      right ventricles and pulmonary arteries, higher mean pulmonary artery pressure 
      (group B 26 mmHg, group A 17 mmHg) and right ventricle end-diastolic pressure 
      (RVEDP group B 10, group A 8.8 mmHg). All defects larger than 10 mm by 
      transesophageal echocardiography (TEE) had Qp/Qs 1.5 or more. Forty patients were 
      operated with zero mortality, in three cases by minithoracothomy. 
      Postoperatively, 50% of group A and 63% of group B felt better, NYHA 
      classification was significantly better in both groups. Tricuspid regurgitation 
      decreased in both groups as well as the size of right ventricle. The size of the 
      left ventricle enlarged after operation in group A. CONCLUSION: This study 
      suggests to operate adults with ASD larger than 10 mm by TEE with signs of right 
      ventricle overload and/or Qp/Qs 1.5 or more, who have normal PAR. Operative 
      mortality was zero in both age groups, the functional repair was better in 
      younger patients (under 40 years).
FAU - Popelova, J
AU  - Popelova J
AD  - Department of Internal Medicine, 2nd Faculty of Medicine, Charles University, 
      Prague, Czech Republic.
FAU - Hlavacek, K
AU  - Hlavacek K
FAU - Honek, T
AU  - Honek T
FAU - Spatenka, J
AU  - Spatenka J
FAU - Kolbel, F
AU  - Kolbel F
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Can J Cardiol
JT  - The Canadian journal of cardiology
JID - 8510280
SB  - IM
MH  - Adult
MH  - Echocardiography, Transesophageal
MH  - Electrocardiography
MH  - Female
MH  - Heart Septal Defects, Atrial/physiopathology/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications
EDAT- 1996/10/01 00:00
MHDA- 1996/10/01 00:01
CRDT- 1996/10/01 00:00
PHST- 1996/10/01 00:00 [pubmed]
PHST- 1996/10/01 00:01 [medline]
PHST- 1996/10/01 00:00 [entrez]
PST - ppublish
SO  - Can J Cardiol. 1996 Oct;12(10):983-8.