THE RESULTS OF SURGERY FOR ATRIAL SEPTAL-DEFECT IN PATIENTS AGED 50 YEARS AND OVER

We examined the cases of 31 patients over the age of 50 years undergoing operative closure of isolated ostium secundum atrial septal defect. The lesion had been diagnosed in all cases prior to cardiac catheterizaton. To assess the importance of pre-operative data on surgical outcome, the patients were first divided into three groups according to mean pulmonary artery pressure (PAP): < 16 mmHg (Group A), 16-30 mmHg (Group B) and > 30 mmHg (Group C). Symptomatic improvement occurred in all groups but more patients in Group C, although symptomatically improved, remained short of breath and in atrial fibrillation than in Group A. Patients in Group A had a higher actual forced vital capacity expressed as a percentage of the predicted value (FVCa/FVCp) than patients in Group B or Group C (P<0-015). There was a good correlation between FVCa/FVCp and percentage oxygen saturation of the arterial blood (P < 00009). This simple non-invasive investigation was therefore found to correlate with previously documented parameters, pulmonary artery pressure and percentage oxygen saturation of the arterial blood, affecting surgical outcome. Patients were also divided into groups according to FVCa/ FVCp: <75% (Group 1) ,50-75% (Group 2) and < 50% (Group3). Postoperative symptoms were more common in Group 3 than in Group 1. We conclude that respiratory function tests, as well as measurement of pulmonary artery pressures, are useful in predicting improvement following atrial septal repair. © 1990 The European Society of Cardiology.