Surgical treatment of adult atrial septal defect: early and long-term results

J Am Coll Cardiol. 1992 Nov 1;20(5):1156-9. doi: 10.1016/0735-1097(92)90372-t.


Objectives: The purpose of this study is to determine the early and late results of the surgical repair of atrial septal defect in adults.

Background: Progressively limiting, untreated atrial septal defect can lead to the early death of middle-aged adults. Recently it has been suggested that the closure of atrial septal defects might be accomplished with interventional cardiac techniques. Although the long-term results of the transcatheter closure are as yet unknown, the outcome of surgical therapy has been shown to be beneficial for almost 40 years.

Methods: Between 1971 and 1991, 166 consecutive patients underwent surgical repair of a secundum or sinus venosus atrial septal defect, or both, at the Brigham and Women's Hospital, Boston. There were 120 women and 46 men in this group; the mean age was 44 years and 58 (35%) of the patients were > or = 50 years old. The average pulmonary to systemic flow ratio was 3.0, and 57 patients had a peak systolic pulmonary artery pressure > 30 mm Hg.

Results: There were two operative deaths (early mortality rate 1.2%), and 13% of the patients had a perioperative complication. One hundred fifty-three of the 164 survivors were followed up for a mean of 90 months (range 2 to 247). There were eight late deaths (late mortality rate 4.9%) and a late morbidity rate of 12.4% (in most cases due to arrhythmias). The 5- and 10-year survival rates are 98% and 94%, respectively, and the probability of event-free survival (with no morbidity or mortality) at 5 years is 97% and at 10 years is 92%.

Conclusions: The results indicate that the surgical correction of atrial septal defect in adults is safe and efficacious as confirmed by 20 years of follow-up.

MeSH terms

  • Adult
  • Age Factors
  • Arrhythmias, Cardiac / epidemiology
  • Boston / epidemiology
  • Cause of Death
  • Female
  • Follow-Up Studies
  • Heart Septal Defects, Atrial / epidemiology
  • Heart Septal Defects, Atrial / mortality
  • Heart Septal Defects, Atrial / surgery*
  • Humans
  • Incidence
  • Life Tables
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Reoperation / statistics & numerical data
  • Sex Factors
  • Survival Rate
  • Time Factors
  • Treatment Outcome