RT Journal Article
SR Electronic
T1 Natural history of secundum atrial septal defect in adults after medical or surgical treatment: a historical prospective study
JF British Heart Journal
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 224
OP 228
DO 10.1136/hrt.71.3.224
VO 71
IS 3
A1 D Shah
A1 M Azhar
A1 C M Oakley
A1 J G F Cleland
A1 P Nihoyannopoulos
YR 1994
UL http://heart.bmj.com/content/71/3/224.abstract
AB Objective—To compare outcome in patients with medically treated secundum atrial septal defect (ASD) first diagnosed after the age of 25 with the long-term outcome in a similar group of patients after surgical closure. Design—A historical, prospective, unrandomised study. Setting—A tertiary referral centre. Patients—All patients with ASD followed up since 1955 who fulfilled the entry criteria and had reached a current age of over 45 years—that is, 34 medical and 48 surgical patients with a mean follow up of 25 years. Main outcome measures—Survival, symptoms, and complications. Results—There was no difference in survival or symptoms between the two groups and no difference in the incidence of new arrhythmias, stroke or other embolic phenomena, or cardiac failure. No patient in either group developed progressive pulmonary vascular disease. Conclusion—Outcome in adults with ASD was not improved by surgical closure. Because progressive pulmonary vascular disease did not develop in any of these patients its prevention is not a reason for advising closure of ASD in adults.