title: The effect of surgical treatment for secundum atrial septal defect in patients more than 30 years old.
abstract: BACKGROUND
  We prospectively examined whether surgical treatment of secundum atrial septal defects in patients 30 years old improves their early- and mid-term clinical outcomes. Our clinical experience is reviewed to assess the importance of surgical management in elderly patients with atrial septal defect.
  
  
  METHODS
  We analyzed 41 patients older than 30 years of age who underwent surgical correction of a secundum atrial septal defect. To evaluate the effects of surgical treatment, we compared functional capacity, diuretic administration, rhythm status, and echocardiographic parameters of all patients before and after the operation.
  
  
  RESULTS
  The median follow-up period was 4.2 years (range, 6 months-7 years). There were no operative deaths. Functional class in most of the patients improved after operation. Two patients reverted to normal sinus rhythm after the operation. There was only one new atrial fibrilation among patients in the postoperative term. Right atrial and right ventricular dimensions and pulmonary artery pressures were significantly decreased, and ejection fractions were significantly increased after the operation. The need for diuretic treatment was decreased after surgical repair. No residual intracardiac shunts were identified during follow-up. There were no cerebrovascular thromboembolic accidents in the early postoperative period.
  
  
  CONCLUSIONS
  Surgical closure of atrial septal defects in patients over 30 years old can improve their clinical status and prevent right ventricular dilatation and insufficiency. The operation must be performed as soon as possible, even if the symptoms or the hemodynamic impact seem to be minimal.
authors.affiliation: Department of Cardiovascular Surgery, Medical Faculty of Ataturk University, Erzurum, Turkey. bilgehanerkut@yahoo.com
authors.forename: Bilgehan
authors.initials: B
authors.lastname: Erkut
authors.forename: Necip
authors.initials: N
authors.lastname: Becit
authors.forename: Yahya
authors.initials: Y
authors.lastname: Unlu
authors.forename: Munacettin
authors.initials: M
authors.lastname: Ceviz
authors.forename: Cevdet Ugur
authors.initials: CU
authors.lastname: Kocogullari
authors.forename: Azman
authors.initials: A
authors.lastname: Ates
authors.forename: Bekir Sami
authors.initials: BS
authors.lastname: Karapolat
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Kaygin
authors.forename: Hikmet
authors.initials: H
authors.lastname: Kocak
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002315:Cardiopulmonary Bypass; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome