Abstract:
The progressive development of pulmonary hypertension
is inevitable in atrial septal defects.
We have carried out a retrospective survey of
patients over the age of 30 years who have been
referred for surgery in the five year period from
1st November 1989. 48 of the 163 patients were
over the age of 30 years. Three were advised
against surgical closure; all 3 were over 50 years
of age, had significant pulmonary hypertension,
and were unlikely to benefit from closure of the
defect. Forty five patients between 30 and 47
years underwent surgical closure, with one early
death due to liver disease. The higher the patient
status according to the NYHA Class, the less
likely were they to have a remission of symptoms,
although no further clinical deterioration
is envisaged in this group. Most of the patients
in their early thirties were still likely to have
amelioration of their symptoms, and improvement
in their cardiac status.
