HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Vijay Agarwal Choudary D. Voleti Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Agarwal, V. Articles by Voleti, C. D. Search for Related Content PubMed Articles by Agarwal, V. Articles by Voleti, C. D. Related Collections Congenital - acyanotic Valve disease

J Thorac Cardiovasc Surg 2009;137:543-547
© 2009 The American Association for Thoracic Surgery

Congenital Heart Disease

Factors predicting the progress of mitral valve disease in surgically treated adults with ostium primum atrial septal defects

^a Department of Cardiothoracic and Vascular Surgery, Sri Sathya Sai Institute of Higher Medical Sciences, Prashantigram, India
^b Department of Cardiology, Sri Sathya Sai Institute of Higher Medical Sciences, Prashantigram, India

Received for publication March 6, 2008; revisions received June 23, 2008; accepted for publication August 28, 2008.

^_* Address for reprints: Suneil K. Aggarwal, MRCP, Department of Cardiology, Sri Sathya Sai Institute of Higher Medical Sciences, Prashantigram, AP 515134, India. (Email: suneilaggarwal{at}doctors.net.uk).

Objective: This study was undertaken to analyze the clinical profile, associated features, and surgical treatments of adults operated on for ostium primum atrial septal defects, particularly factors influencing progression of mitral valve disease.

Methods: We retrospectively studied all patients aged 18 years and older operated on at our institution with reference to patient clinical features, investigation findings, surgical records, and outpatient follow-up data.

Results: Fifty-one patients, 29 female and 22 male, underwent operation at a mean age of 27.3 years (SD 6.9). Of these, 80% were in New York Heart Association functional class I or II, with a most frequent presenting symptom of dyspnea. On echocardiography, 88% had cleft mitral valve, 35% had moderate mitral regurgitation, and 4% had severe mitral regurgitation. According to echocardiography and available cardiac catheterization data, 27% had moderate pulmonary arterial hypertension and 8% had severe. In-hospital mortality was 1.9%. At mean follow-up of 36 months, 94% of patients were in functional class I. Mitral regurgitation was moderate in 21% and severe in 8%, with 1 patient undergoing mitral valve replacement. Factors associated with increased risk of moderate or severe mitral regurgitation on follow-up were preoperative moderate or severe pulmonary arterial hypertension (P = .008) and female sex (P = .009).

Conclusion: Surgical correction of ostium primum atrial septal defects in adults can be undertaken successfully with low mortality and excellent symptomatic results. Regular follow-up is required to assess progression of mitral regurgitation, which is more likely in women and those with preoperative pulmonary arterial hypertension.

This article has been cited by other articles:

				S. Talwar, V. Singh, N. Chandra, A. Marwah, and R. Sharma Challenges in Delayed Repair of Atrioventricular Septal Defects World Journal for Pediatric and Congenital Heart Surgery, April 1, 2010; 1(1): 87 - 90. [Abstract] [Full Text] [PDF]