[Influence of age-related complications on clinical outcome in patients with surgical repair of atrial septal defect].
BACKGROUND
The influence of perioperative characteristics on postoperative outcome has been obscure in the adult patients with atrial septal defect (ASD). This study was designed to investigate whether perioperative patient profiles and complications will contribute to postoperative outcome following surgical closure of ASD in adult patients.


METHODS
Subjects were 39 (17 male and 22 female) ASD patients, aged 16 to 69 years (mean 53 +/- 15) who were scheduled for surgical repair of isolated secundum ASD between 1999 to 2003. All patients were evaluated for circulatory characteristics using echocardiography and cardiac catheterization. Postoperative complications were evaluated by examining duration of postoperative oxygen requirement, postoperative duration until first ambulation, intubation and hospital stay after surgery.


RESULTS
In elderly group (over 50 years of age), preoperative %FEV1.0, preoperative oxygen index and creatinine clearance were lower compared with those of younger group (under 50 years of age) (P=0.0309, P= 0.0341 and P= 0.0112, respectively). Moreover, elderly group showed longer duration of oxygen requirement compared with younger group (3 +/- 5 days and 2 +/- 1 days; P=0.0273). Age and change of the left ventricular diastolic diameter (LVDd) affected the incidence of postoperative arrhythmia (P=0.0195 and P=0.0204). Preoperative oxygen index and %VC affected long term intubation (P=0.0201 and P=0.0363). TAP, smoking and pulmonary hypertension affected long term oxygen supply (P=0.0070, 0.0349 and 0.0355). Only %VC affected postoperative duration until first ambulation (P = 0.0219). Delirium and postoperative oxygen index affected the length of hospitalization (P=0.0072 and 0.0188).


CONCLUSIONS
Respiratory function was important in short-term outcomes in the patients with ASD. In addition, preoperative small LVDd was a useful predictor for postoperative atrial fibrillation.
Kita
Takashi
T
Department of Anesthesiology, Osaka Police Hospital.
Maki
Naritoshi
N
Hori
Tatsuyuki
T
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001145:Arrhythmias, Cardiac / Q000209:etiology; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D051437:Renal Insufficiency / Q000209:etiology*; D012131:Respiratory Insufficiency / Q000209:etiology*; D016896:Treatment Outcome