성인 심방중격결손증의 수술교정

Surgical Correction of Atrial Septal Defect in Adult

  • 발행 : 1995.09.01

초록

Repairs of atrial septal defect utilizing cardiopulmonary bypass were performed in 50 adults, ranging age from 16 to 53 years, since April 1986 up to October 1994. They occupied 38.8% of all adult congenital heart disease operated in the same period. Preoperatively, 16 patients were functional class II, 12 patients class III and 4 patients class IV[New York Heart Association Classification , respectively. Five patients combined with atrial fibrillation and the remainders revealed regular sinus rhythm. Cardiac catheterizations were performed in 43 out of 50 patients, and revealed a systolic pulmonary arterial pressure in excess of 51 mmHg in 4 patients but none had reversed shunt. 40 patients[80% were repaired with patch closure and remainings were repaired with direct closure. 49 patients were followed up for 2 months up to 102 months[average 55 months . A comparison of the preoperative and postoperative functional class demonstrated a mean decrease of one NYHA functional level[2.5$\pm$0.63 to 1.4$\pm$0.56 . There was no operative mortality. One patient died during the follow-up period and the death was unrelated to heart disease. Operative treatment is indicated for repair of atrial septal defect with left to right shunt in the adult patient and a considerable clinical improvement can be anticipitated with low mortality.

키워드

참고문헌

  1. Am. J. Cardiol. v.17 Congenital cardiovascular anomalies in adults;Results of surgical treatment in 167 patients over the age 35 Cooley,D.A.;Hallman,G.I.;Hamman,A.S.
  2. Br. Heart J. v.32 Natural history of atrial septal defect Campbell,M.
  3. Circulation v.37 Natural history and prognosis of atrial septal defect Craig,R.J.;Selzer,A.
  4. Br. Heart J. v.30 Atrial septal defect in patients over 45 years of age;Merits of surgical versus medical therapy Wolf,P.S.;Vogel,J.H.K.;Pryor,R.;Blount,S.G.
  5. JAMA v.200 Life expectancy with atrial septal defect;Influence of complicating pulmonary vascular disease Dalen,J.E.;Haynes,F.W.;Dexter,L.
  6. Am. Heart J. v.94 Atrial septal defect of secundum type in the middle-aged Forfang,K.;Simonsen,S.;Anderson,A.;Efskind,L.
  7. 대흉외지 v.25 성인의 선천성 심질환 정신현;조광현;황윤호(등)
  8. 대흉외지 v.13 성인의 선천성 심장질환의 외과적교정 김광호;김은기;조범구;홍승록
  9. Am. J. Cardiol. v.53 Ostium secundum atrial septal defect-Survival for 87 and 94 years Perloff,J.K.
  10. Arch. Intern. Med. v.121 Atrial fibrillation in atrial septal defect Tikoff,G.;Schmidt,A.M.;Hecht,H.H.
  11. Am. J. Cardiol. v.12 Natural history of atrial septal defect with criteria for selection for surgey Mark,H.
  12. Circulation v.35;36 no.SUP. Ⅰ Results of operation for atrial septal defect in patients forty-five years of age and older Daicoff,G.R.;Brandenburg,R.O.;Kirklin,J.W.
  13. Circulation v.64 Atrial septal defect in patients ages 60 years or older;Operative results and long-term postoperative follow-up St.John Sutton,M.G.;Tajik,A.J.;McGoon,D.C.
  14. Circulation v.19 Atrial septal defect : Factors affecting the surgical mortality rate McGoon,D.C.;Swan,H.J.C.;Brandenburg,R.O.;Connoly,D.C.;Kirklin,J.W.
  15. Circulation v.37 Atrial septal defect in patients over the age of forty years Gault,J.H.;Morrow,A.G.;Gay,W.A.;Ross,J.
  16. Circulation v.76 Isolated atrial septal defect with pulmonary vascular obstructive disease-Long-term follow-up and prediction of outcome after surgical correction Steele,P.M.;Fuster,V.;Cohen,M.;Ritter,D.G.;McGoon,D.C.
  17. Am. J. Cardiol. v.31 Atrial septal defect in adults;Clinical and hemodynamic results of surgery Dave,K.S.;Pakrashi,B.C.;Wooler,G.H.;Ionescu,M.I.
  18. Arch. Surg. v.123 Surgical closure of atrial septal defect in patinents older than 50 years of age Fiore,A.C.;Naunheim,K.S.;Kessler,K.A.(et al.)
  19. Circulation v.39;40 no.SUP. Ⅰ Embolic complications following repair of atrial septal defects Hawe,A.;Rastelli,G.C.;Braundenburg,R.O.;McGoon,D.G.
  20. N. Engl. J. Med. v.323 The effect of low-dose warfarin on the risk of stroke in patients with nonrheumatic atrial fibrillation The Boston Area Anticoagulation Trial for Atrial Fibrillation Investigators