Late postoperative follow-up of ostium secundum defect

Abstract

Aim. To perform late postoperative assessment of patients with ostium secundum defect. Methods. We studied 45 patients 22 ± 4 years after operation using clinical examination, transthoracic and transoesophageal echocardiography and electrocardiography. Results. Patients operated on at ≤ 24 years had normal exercise tolerance while 11/17 (65%) patients operated on at > 24 years reported dyspnoea upon exercise. Mitral regurgitation occurred more frequently in patients operated on at ≤ 24 years than at > 24 years (29% vs 69%, P < 0.05). Tricuspid regurgitation was mild in 20 patients (45%). There was an inter-atrial communication in 13 patients (28%). Eighteen patients (40%) had an enlarged right ventricular diameter. A tricuspid regurgitation gradient > 30 mmHg was measured in seven patients (16%). Seventeen patients (38%) had signifcant electrocardiographic abnormalities. Conclusions. Late after uncomplicated seclusion of ostium secundum defect patients operated at > 24 years have more symptoms than those operated on at an earlier age. Residual lesions are common. Mitral regurgitation is more frequent in patients operated on at > 24 years. Our findings support the clinical consensus of operating on these patients in their childhood and adolescence.