title: Is there a role for surgery in the management of isolated secundum atrial septal defect in adults?
abstract: OBJECTIVE
  The aim of this retrospective study was to compare the short-term outcomes of surgical versus transcatheter closure of secundum atrial septal defect (ASD) in adults.
  
  
  METHODS
  From January 2008 to October 2012, 229 patients aged 18 years and older with significant isolated secundum ASDs were admitted to our hospital. We focused only on objective data obtained from their medical records. We collected and compared a total of 163 patients with isolated secundum ASD, who were treated with device occlusion or surgical closure, and had no missing data. Postoperative outcomes, rhythm disturbances, residual ASD, infection rates and length of hospital stay were compared.
  
  
  RESULTS
  Complete follow-up data were available for 42 (46%) patients in the device group and for 121 (87%) in the surgery group. Complete closure was observed in 41 of the 42 patients (97.6%) in the device group (p = 0.258) and in all 121 in the surgery group (100 %) (p > 0.05). There were no mortalities. The mean length of hospital stay in the device group was 1.92 ± 0.43 days and in the surgery group 7.14 ± 0.14 days (p < 0.01).
  
  
  CONCLUSIONS
  The transcatheter approach for closure of ASDs is an effective and safe treatment option when performed for certain indications. Broadening the spectrum of indications may cause some adverse events. Surgical treatment remains a good alternative for all patients with ASDs and can be performed safely in order not to increase procedure-related complications.
authors.affiliation: Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Bolcal
authors.affiliation: Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Arslan
authors.affiliation: Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Kadan
authors.affiliation: Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Suat
authors.initials: S
authors.lastname: Doganci
authors.affiliation: Department of Cardiology, Gulhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Cem
authors.initials: C
authors.lastname: Barcin
authors.affiliation: Department of Cardiology, Gulhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Atilla
authors.initials: A
authors.lastname: Iyisoy
authors.affiliation: Department of Anesthesiology, Gulhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Vedat
authors.initials: V
authors.lastname: Yildirim
authors.affiliation: Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Arslan
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D055989:Septal Occluder Device; D016896:Treatment Outcome; D055815:Young Adult