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Benefit of ASD closure in different age groups

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Introduction

Untreated atrial septal defect (ASD) leads to various complications. These complications can be modified to a variable extent after closure of the defect, depending upon the age at the time of closure. While some patients get the total benefit of ASD closure, others are better left alone than undergo closure.

Purpose

We aimed to evaluate how the closure of ASD modifies the cardiopulmonary status during long follow up in different age groups.

Material and methods

Our study included 224 patients operated in last 20 years. They were divided into three age groups, viz. less than 20 years, 20 to 40 years, and more than 40 years. The clinical and investigative data about each patient’s preoperative cardiopulmonary status was compared with postoperative status using appropriate statistical method.

Results

Prevalence of arrhythmia and pulmonary artery hypertension (PAH) was predominant in advanced age group. Each of these showed favorable improvement after surgical closure; however, the effect was more pronounced in younger age groups. Persistence or new onset arrhythmia was seen in older patients; the trend however was not significant. There was a significant positive correlation between arrhythmia and PAH grade. Right ventricular remodeling in follow up was significant in patients more than 20 years of age. The New York Heart Association (NYHA) functional class also showed a significant improvement to better class in all age groups.

Conclusion

We conclude that definite morbidity in older patients is a strong argument favoring surgical closure early in life. In the older age group, hemodynamic benefits are much less pronounced and should be taken into account before surgical treatment is advised.

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Authors and Affiliations

  1. Department of CVTS, Sher-i-Kashmir Institute of Medical Sciences, Room F-20, SR Hostel, Block C, SKIMS, Srinagar, JK, 190011, India

    Wahid Syed, Majeed Dar, Hakeem Zubair Ashraf, Ghulam Nabi Lone, Shyam Singh, Farooq Ganie & Mudasir Sidiq

Authors
  1. Wahid Syed
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  2. Majeed Dar
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  3. Hakeem Zubair Ashraf
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  4. Ghulam Nabi Lone
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  5. Shyam Singh
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  6. Farooq Ganie
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  7. Mudasir Sidiq
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Corresponding author

Correspondence to Wahid Syed.

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Declaration by the corresponding author

I certify that I have no commercial or non-commercial associations that might pose a conflict of interest in connection with the submitted article. It is further certified that none among the co-authors of the submitted article has any conflict of interest.

Research involving human participants and/or animals

All procedures performed in this study involved only human participants and were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare that they have no conflict of interest.

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Syed, W., Dar, M., Ashraf, H.Z. et al. Benefit of ASD closure in different age groups. Indian J Thorac Cardiovasc Surg 33, 123–127 (2017). https://doi.org/10.1007/s12055-017-0527-9

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  • DOI: https://doi.org/10.1007/s12055-017-0527-9

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