Asd in Patients Over 40 Years of Age

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Abstract
To evaluate the benefits of operative treatment of congenital heart disease in older age groups, a clinical study on patients over 40 years of age with atrial septal defect was carried out. The series consisted of 125 consecutive patients operated on between 1966 and 1974. There were 8 cases with a primum, 12 cases with a sinus venosus type of secundum and 105 cases with a simple secundum defect. The operative mortality was 2 patients (1.6%). It was due to myocardial infarction in one case and high pulmonary vascular resistance in the other. On re-examination 3-6 months postoperatively, 107 patients were improved, 13 patients unchanged and 3 patients were worse than before operation. On re-evaluation after an average period of 6 years, 88 patients were still improved. 32 patients unchanged and 3 patients were worse compared with their pre-operative status. On the basis of the results and the previous reports on atrial septal defect without operation, the surgical correction of ASD even in older age groups can be recommended. The problem of deterioration of some patients, despite a good immediate postoperative result, is discussed.