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European Heart Journal 1999 20(12):904-909; doi:10.1053/euhj.1998.1349
Copyright © 1999 by the European Society of Cardiology.
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Late postoperative follow-up of ostium secundum defect

K.W.E. Groundstroemf1, T.E. Iivainen, T. Talvensaari and J.T. Lahtela

Departments of Medicine, Clinical Physiology, Tampere University Hospital, Tampere, Finland

revised October 1, 1998; accepted October 7, 1998

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 >30mmHg was measured in seven patients (16%). Seventeen patients (38%) had significant 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.

Key Words: Ostium secundum defect • echocardiography • mitral valve transoesophageal echocardiography • postoperative • surgery

f1 Correspondence : Kaj Groundstroem, Department of Medicine,Tampere University Hospital, FIN-33520 Tampere, Finland.


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