Late postoperative follow-up of ostium secundum defect.

Abstract

To perform late postoperative assessment of patients with ostium secundum defect. We studied 45 patients 22+/-4 years after operation using clinical examination, transthoracic and transoesophageal echocardiography and electrocardiography. 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 significant electrocardiographic abnormalities. 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.