title: Do patients over 40 years of age benefit from surgical closure of atrial septal defects?
abstract: OBJECTIVE
  To determine the value of surgical closure of atrial septal defects in patients over 40 years of age.
  
  
  METHODS
  Retrospective analysis of 76 patients (63 women, 13 men), age range 40-62 years (mean (SD) 45.8 (5.1) years), who underwent surgical repair of atrial septal defect. Pre- and postoperative clinical status (New York Heart Association (NYHA) functional class) was assessed, and ECG, x ray, and echocardiographic investigations performed. Follow up was between 1 and 17 years.
  
  
  RESULTS
  One operative and one late death occurred during the study period. Before operation, 47 patients (61.8%) were in NYHA functional classes III and IV. After operation, 61 patients (82.4%) were in classes I and II. Four patients had atrial fibrillation before surgery versus nine after surgery. Before operation, 52 patients had intensified pulmonary vascularity compared with only seven after operation. Echocardiographic examination showed a significant reduction in right ventricular dimension (4.10 (0.91) v 2.95 (0.36) cm, p < 0.001). No residual intracardiac shunts were identified on echocardiographic follow up.
  
  
  CONCLUSIONS
  Surgical closure of atrial septal defects in patients over 40 years old can improve their clinical status and prevent right ventricular dilatation and insufficiency.
authors.affiliation: Department of Cardiac Surgery, Institute of Cardiology, Karol Marcinkowski University of Medical Sciences, Poznań, Poland. mjemielity@poland.com
authors.forename: M
authors.initials: M
authors.lastname: Jemielity
authors.forename: W
authors.initials: W
authors.lastname: Dyszkiewicz
authors.forename: L
authors.initials: L
authors.lastname: Paluszkiewicz
authors.forename: B
authors.initials: B
authors.lastname: Perek
authors.forename: P
authors.initials: P
authors.lastname: Buczkowski
authors.forename: A
authors.initials: A
authors.lastname: Ponizyński
mesh_terms: D000328:Adult; D000367:Age Factors; D001145:Arrhythmias, Cardiac / Q000209:etiology; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D014463:Ultrasonography