Atrial septal defect post surgical prognosis: Difference between revisions
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==Post-surgical prognosis== | ==Post-surgical prognosis== | ||
===Age and pulmonary pressure=== | ===Age at surgery and pulmonary pressure=== | ||
'''1)''' Age ≤ | '''1)''' Age ≤ 25 years- Survival rates comparable to age and sex-matched control subjects. | ||
'''2)''' | '''2)''' 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 systolic pressure ≥40 mm Hg, late survival is 50% less than control rates | |||
'''2)''' Age ≤ 45 years + no comorbidities like heart failure, pulmonary artery pressures less than 60 mm Hg. - Mortality rate post surgery ≤1%. | |||
'''3)''' | '''3)''' Age ≥ 60 years + no serious comorbidities - ASDs should be closed as early as possible as surgery causes an improvement in symptoms | ||
'''4)''' Life expectancy in surgically treated older patients is better than that of medically treated patients. | '''4)''' Life expectancy in surgically treated older patients is better than that of medically treated patients. | ||
==See also== | ==See also== | ||
Revision as of 15:38, 11 September 2011
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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) 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 systolic pressure ≥40 mm Hg, late survival is 50% less than control rates
2) Age ≤ 45 years + no comorbidities like heart failure, pulmonary artery pressures less than 60 mm Hg. - Mortality rate post surgery ≤1%.
3) Age ≥ 60 years + no serious comorbidities - ASDs should be closed as early as possible as surgery causes an improvement in symptoms
4) Life expectancy in surgically treated older patients is better than that of medically treated patients.