title: Mid- to Long-term Results of Surgical Treatment of ASD in Patients over 60 Years Old.
abstract: BACKGROUND
  There is controversy about the benefit of surgical correction of an atrial septal defect (ASD) in patients over 60 years old. The purpose of this study was to determine whether surgical treatment is beneficial in those 60 years of age or older.
  
  
  METHODS
  We reviewed the clinical course of 57 patients (mean age: 63.54±5.59 years) diagnosed with an isolated secundum ASD after the age of 60. The 24 patients (group A) who underwent surgical repair were compared with the 33 patients (group B) who were treated non-surgically. The mean follow-up period was 6.8±4.5 years.
  
  
  RESULTS
  One operative death, 5 late deaths (20.8%) in group A, and 9 deaths (27.3%) in group B occurred in the study period. Symptomatic improvement was noted in 18 patients (75%) of group A after surgery. However 13 patients (39.4%) of group B showed symptomatic improvement during the follow-up period (p=0.012). The incidence of new atrial arrhythmia of the two groups was significantly different (16.7% vs 36.7%, p=0.038). The actuarial 10 year survival rate was 79% in group A and 73% in group B.
  
  
  CONCLUSIONS
  Although surgical correction of ASD did not increase survival in patients over 60 years old, the surgical outcomes of ASD showed low operative mortality and resulted in symptomatic improvement in the majority of these patients. This study has shown the benefits of surgical closure of ASD even in advanced age in comparison to medical treatment.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, College of Medicine, Chonnam National University, Korea.
authors.forename: In-Seok
authors.initials: IS
authors.lastname: Jeong
authors.forename: Byoung-Hee
authors.initials: BH
authors.lastname: Ahn
authors.forename: Soon-Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Sang-Gi
authors.initials: SG
authors.lastname: Oh
authors.forename: Bong-Suk
authors.initials: BS
authors.lastname: Oh
authors.forename: Sang-Hyung
authors.initials: SH
authors.lastname: Kim