title: Surgical treatment of secundum atrial septal defect in patients older than 50 years.
abstract: BACKGROUND
  The aim of this study was to verify if surgery is beneficial for patients older than 50 years.
  
  
  METHODS
  Sixty-five patients older than 50 years were operated for a secundum atrial septal defect between November 1974 and November 1998. Preoperative data were obtained from hospital records; postoperative data from written questionnaires or direct telephone interviews. A comparison of pre and postoperative data was possible in 53 patients.
  
  
  RESULTS
  The operative mortality was 0%. One patient died of a thromboembolic complication 32 days after surgery. The mean follow-up was 9 +/- 6 years. After surgery, clinical improvement occurred in 22 patients (41.5%) with the majority of them (69.8%) being asymptomatic or only mildly symptomatic. The occurrence of atrial fibrillation/flutter did not decrease after surgery (39.6 vs 26.4%). A thromboembolic event occurred in 2 patients before surgery and in 2 patients postoperatively; all of them had supraventricular arrhythmias and were not taking anticoagulants.
  
  
  CONCLUSIONS
  Surgical closure of atrial septal defects in patients older than 50 years is feasible. The mortality is low. In this age group, surgery has a beneficial effect on the clinical status of the patients but not on the occurrence of supraventricular arrhythmias that can affect morbidity and mortality in patients who are not treated with anticoagulants.
authors.affiliation: Institute of Cardiovascular Diseases, University of Bologna, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Donti
authors.forename: M
authors.initials: M
authors.lastname: Bonvicini
authors.forename: A
authors.initials: A
authors.lastname: Placci
authors.forename: D
authors.initials: D
authors.lastname: Prandstraller
authors.forename: G
authors.initials: G
authors.lastname: Gargiulo
authors.forename: L
authors.initials: L
authors.lastname: Bacchi-Reggiani
authors.forename: A
authors.initials: A
authors.lastname: Pierangeli
authors.forename: F M
authors.initials: FM
authors.lastname: Picchio
mesh_terms: D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000188:drug therapy / Q000209:etiology; D013504:Cardiovascular Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D000925:Anticoagulants