Surgical treatment of atrial septal defect in adults: the effect of age at operation on postoperative cardiopulmonary exercise capacity [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2007; 35(2): 83-89

Surgical treatment of atrial septal defect in adults: the effect of age at operation on postoperative cardiopulmonary exercise capacity

Sait Terzi1, Nurten Sayar1, Tuba Bilsel1, İsmail Erdem1, Sezai Çelik2, Yavuz Enç3, Burak Tangürek1, Nihat Özer1, Kemal Yeşilçimen1
1Department Of Cardiology, Siyami Ersek Cardiovascular And Thoracic Surgery Center, Istanbul, Turkey,
2Department Of Thoracic Urgery, Siyami Ersek Cardiovascular And Thoracic Surgery Center, Istanbul, Turkey
3Department Of Cardiovascular Surgery, Siyami Ersek Cardiovascular And Thoracic Surgery Center, Istanbul, Turkey


OBJECTIVES
We investigated the effect of age at the time of atrial septal defect (ASD) closure in adults on cardiopulmonary exercise capacity.

STUDY DESIGN
Fifty-one adult patients (12 men, 39 women; mean age 39 years) underwent surgical repair for isolated ASD. The patients were divided into two groups according to their ages at the time of surgery, i.e. group 1 <40 years, and group 2 ≥40 years of age. Cardiopulmonary exercise capacity was evaluated postoperatively. The results were compared with those of 37 healthy controls (12 men, 25 women; age range 17 to 60 years). The mean follow-up was 2.5±1.3 years (range 1.5 to 5 years).

RESULTS
Postoperatively, an improvement of at least one NYHA functional class was found in 32 patients (62.8%). The incidence of atrial fibrillation remained unchanged (16.1% in group 1, 25% in group 2). Pulmonary hypertension decreased from 22.6% to 16.1% in group 1, and from 45% to 30% in group 2. Compared to controls, peak oxygen uptake (VO2) and all other parameters of cardiopulmonary exercise capacity were significantly lower in the study group. Peak VO2 showed a higher improvement in group 1 than that in group 2 (76.5% vs 68.3% of peak VO2 in age-matched controls). Similarly, patients without pulmonary hypertension had a higher peak VO2 than those with pulmonary hypertension (78.1% vs 64.7% of peak VO2 in age-matched controls). Peak VO2 values of patients who had NYHA class 1, 2, and 3 functional capacity preoperatively were 92.7%, 78.6%, and 52.7% of that in the control group, respectively.

CONCLUSION
Limitations in exercise capacity of adult patients following ASD repair are associated with age at operation, pulmonary artery pressure, and preoperative functional capacity.

Keywords: Adult, age factors, exercise test, heart septal defects, atrial/surgery; oxygen consumption

How to cite this article
Sait Terzi, Nurten Sayar, Tuba Bilsel, İsmail Erdem, Sezai Çelik, Yavuz Enç, Burak Tangürek, Nihat Özer, Kemal Yeşilçimen. Surgical treatment of atrial septal defect in adults: the effect of age at operation on postoperative cardiopulmonary exercise capacity. Turk Kardiyol Dern Ars. 2007; 35(2): 83-89

Corresponding Author: Sait Terzi, Türkiye
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