Atrial septal defect post surgical prognosis: Difference between revisions
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{{Atrial septal defect}} | {{Atrial septal defect}} | ||
{{CMG}}; '''Associate Editors-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto: | {{CMG}}; '''Associate Editors-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh13579@gmail.com]; {{CZ}}; '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@elon.edu] | ||
==Overview== | ==Overview== | ||
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'''1)''' Surgical closure during childhood - Late onset supraventricular [[arrhythmias]]. The reason for these could be: | '''1)''' Surgical closure during childhood - Late onset supraventricular [[arrhythmias]]. The reason for these could be: | ||
* Patchy fibrosis of the right [[atrium] secondary to dilatation | * Patchy fibrosis of the right [[atrium]] secondary to dilatation | ||
* [[SA node]] dysfunction | * [[SA node]] dysfunction | ||
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'''3)''' Common in the [[Atrial septal defect sinus venosus|sinus venosus]] type than in the [[Ostium secundum atrial septal defects|ostium secundum]] type. | '''3)''' Common in the [[Atrial septal defect sinus venosus|sinus venosus]] type than in the [[Ostium secundum atrial septal defects|ostium secundum]] type. | ||
== | ==Related Chapters== | ||
*[[Atrioventricular septal defect]] | *[[Atrioventricular septal defect]] | ||
*[[Congenital heart disease]] | *[[Congenital heart disease]] | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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[[CME Category::Cardiology]] | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
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[[Category:Overview complete]] | [[Category:Overview complete]] | ||
[[Category:Up-To-Date]] | [[Category:Up-To-Date]] | ||
Latest revision as of 02:24, 15 March 2016
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Atrial Septal Defect Microchapters | |
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Treatment | |
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Surgery | |
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Special Scenarios | |
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Case Studies | |
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Atrial septal defect post surgical prognosis On the Web | |
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American Roentgen Ray Society Images of Atrial septal defect post surgical prognosis | |
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Risk calculators and risk factors for Atrial septal defect post surgical prognosis | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]
Overview
Post-surgical prognosis depends on type of defect, amount of shunting, age at surgery and pulmonary pressure. Early mortality is approximately 1% in the absence of pulmonary hypertension or other major comorbidities. Long-term follow-up is excellent, and preoperative symptoms decrease or abate. The incidence of atrial fibrillation/flutter is reduced when concomitant antiarrhythmic procedures (eg, Maze) are performed; however, atrial arrhythmias may occur de novo after repair.The need for reoperation of residual/recurrent ASD is uncommon. Superior vena cava stenosis or pulmonary vein stenosis may occur after closure of sinus venosus ASD.
Post-surgical prognosis
Age at surgery and pulmonary pressure
1) Age ≤ 25 years- Survival rates comparable to age and sex-matched control subjects.
2) Age 25-40 years - Surgical survival reduced compared to surgical repair ≤ 25 years
- Pulmonary artery pressures are normal- survival comparable with surgery done at ≤ 25 years.
- Pulmonary artery pressure ≥40 mm Hg- Late survival 50% less than control rates
2) Age ≤ 45 years + no comorbidities like heart failure, pulmonary artery pressures ≤60 mm Hg. - Mortality rate post surgery ≤1%.
3) Age ≥ 60 years + no serious comorbidities - Atrial septal defect should be closed as early as possible as surgery can cause an improvement in symptoms
4) Life expectancy in surgically treated older patients is better than that of medically treated patients.
5) Patient's age at time of surgical closure is a good predictor of development of atrial arrhythmias as complications.
6) Atrial fibrillation, stroke, and heart failure common after surgical repair in adult.
Post-surgical arrhythmias
1) Surgical closure during childhood - Late onset supraventricular arrhythmias. The reason for these could be:
2) Surgical closure in adults -
- Atrial fibrillation may continue post surgery and require cardioversion and antiarrhythmics treatment.
- Age at surgery ≥40 years- 1/2 patients with preoperative normal sinus rhythm will develop postoperative atrial fibrillation.
3) Common in the sinus venosus type than in the ostium secundum type.