title: Congenital heart disease in patients over 40 ears old who have not undergone cardiac surgery.
abstract: The histories and medical courses were reviewed in 154 patients with congenital heart disease (CHD) ranged in age 40 to 77 years (mean 48.8 years) who had not yet undergone cardiac surgery. The CHD most commonly involved were atrial septal defect (ASD)(63.6%), ventricular septal defect (13.6%) and patent ductus arteriosus (8.4%). There were no cases of tetralogy of Fallot or of transposition of the great arteries in this study. Hemodynamic observations showed no significant correlation between the age and systolic pulmonary artery pressure in left-to-right shunt disease. Mortality due to cardiac failure was higher in patients whose systolic pulmonary artery pressure was over 50 mmHg. 91 patients had cardiac surgery and surgical mortality was 7% (6 patients). There was one late ASD death, and 46% are in good condition (NYHA I). In patients without surgery, 27% (17 patients) died of cardiac failure except one, and 11% (6 patients) are in good condition. Among factors affecting prognosis, pulmonary vascular changes are the most important, with arrhythmia and myocardial damage occurring with age, and complications like infective endocarditis and coronary sclerosis affecting prognosis adversely.
mesh_terms: D000328:Adult; D000368:Aged; D004374:Ductus Arteriosus, Patent / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000503:physiopathology* / Q000601:surgery; D006344:Heart Septal Defects, Atrial / Q000503:physiopathology; D006345:Heart Septal Defects, Ventricular / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011669:Pulmonary Wedge Pressure