Cardiologie clinique et expérimentale
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Improvement after Surgical Closure of Secundum Atrial Septal Defects in Adults

Ayman M. Shaalan*, Eman E. Elwakeel, Hany M. Elrakhawy, Mohamed A. Alassal and Abdelaziz Gomaa

Background: Atrial septal defect (ASD) is the most common congenital heart disease (CHD) in adults after bicuspid aortic valve. Although the defect is often asymptomatic until adulthood, undetected ASDs could lead to potential irreversible complications like arrhythmias, stroke, pulmonary hypertension and its squeal.

The purpose of our study was to determine the value of surgical closure of atrial septal defects in adults and the effect of age on the prognosis of these patients.

Methods and patients: Retrospective study was carried out on 489 patients with age 18 to 65 years old who underwent surgical repair of isolated Secundum type ASD. There were 318 women and 171 men (mean age was25.21 ± 10.106 years). The patients were divided into two groups, group I: from 18-40 years old. Group II: 40-65 years old. Preoperative, operative, and postoperative data were reviewed. Statistical analysis was performed.

Results: A statistically significant improvement of NYHA Functional class, tricuspid valve regurgitation and pulmonary artery pressure in most of the patients after operation. No residual intra-cardiac shunt was identified on echocardiographic follow up. Postoperative morbidity and mortality were higher in the older patients with high pulmonary pressure.

Conclusion: Surgery for ASD in the adult age is a safe, beneficial, and a low-risk option that modifies the patient’s natural history by improving their clinical status. The operation must be performed without major delay, better to be in established GUCH centers by well trained staff. Despite the use of sildenafil is still need more research. It seems to have good result post-operative.