title: Preoperative and postoperative mitral valve prolapse and regurgitation in adult patients with secundum atrial septal defects.
abstract: BACKGROUND
  Little attention is given to development of mitral regurgitation (MR) in adults with atrial septal defect (ASD). The aim of the study was to determine the associated factors of MR in ASD adults before surgical repair and the fate of moderate to severe MR after surgery.
  
  
  METHODS
  We examined 71 consecutive patients with secundum ASD (47 +/- 16 years) who underwent surgical repair. Clinical and echocardiographic variables including size of left and right heart systems and severity of MR and tricuspid regurgitation (TR) were investigated before and early after surgery.
  
  
  RESULTS
  Before ASD closure, 14 patients (20%) had moderate to severe MR and 25 patients (35%) showed mitral valve (MV) prolapse. The ASD patients with moderate to severe MR showed worse cardiovascular symptoms, increased occurrence of atrial fibrillation and MV prolapse, and greater left ventricular (LV) end-diastolic volume, left atrial area, and TR severity than those with none to mild MR (all P < 0.05). Among preoperative variables, TR severity, left atrial area, LV end-diastolic volume, and MV prolapse were associated with preoperative MR severity in all the patients (all P < 0.03). Isolated ASD closure (n=46) decreased MV prolapse (P=0.008). Preoperative moderate to severe MR decreased after ASD closure with and without MV surgery (n=9 and 5, respectively; both P < 0.05).
  
  
  CONCLUSIONS
  Preoperative MR severity was associated with TR severity, dilated left heart chambers, and MV prolapse. MR decreased after ASD closure with and even without MV surgery.
authors.affiliation: Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH 44195, USA.
authors.forename: Manatomo
authors.initials: M
authors.lastname: Toyono
authors.forename: Gosta B
authors.initials: GB
authors.lastname: Pettersson
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Matsumura
authors.forename: Nozomi
authors.initials: N
authors.lastname: Wada
authors.forename: Shota
authors.initials: S
authors.lastname: Fukuda
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Yamano
authors.forename: Kunitsugu
authors.initials: K
authors.lastname: Takasaki
authors.forename: Takahiro
authors.initials: T
authors.lastname: Shiota
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications; D012015:Reference Standards; D012189:Retrospective Studies