Excellent survival and low incidence of arrhythmias, stroke and heart failure long-term after surgical ASD closure at young age. A prospective follow-up study of 21-33 years
Open accessAbstract
AIMS: Although studies have suggested good long-term results, arrhythmias, pulmonary hypertension and left ventricular dysfunction are mentioned as sequelae long-term after surgical atrial septal defect closure at young age. Most studies were performed only by questionnaire and in a retrospective manner. The long-term outcome is very important with regard to future employment and acceptance on insurance schemes. METHODS AND RESULTS: One hundred and thirty-five consecutive ASD-patients, operated on in childhood, were studied longitudinally with ECG, echocardiography, exercise testing and Holter-recording 15 (10-22) and 26 (21-33) years after surgery. During follow-up no cardiovascular mortality, stroke, heart failure and no pulmonary hypertension occurred. Symptomatic supraventricular tachyarrhythmias were present in 6% after 15 years, and an additional 2% occurred in the last decade; 5% needed pacemaker implantation. No relation was found between arrhythmias and type of ASD, baseline data, right ventricular dimensions, or age at operation. Left and right ventricular function and dimension remained unchanged. Slightly more patients had right atrial dilatation at last follow-up. Exercise capacity was comparable with the normal Dutch population. CONCLUSIONS: The long-term outcome after ASD closure at young age shows excellent survival and low morbidity. The incidence of supraventricular arrhythmias is lower than in natural history studies of ASD patients and also lower than after surgical correction at adult age.
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Early repair can reduce but not eliminate the risk of AF in atrial septal defects.
“Early repair can reduce but not eliminate the risk of AF. 973”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [973]
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- Authors
- Roos-Hesselink, J.
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2003-01
- Volume
- 24
- Issue
- 2
- Pages
- 190-197
- ISSN
- 0195-668X (ISSN-L)
- OpenAlex
- W1847769506
- Cited by
- 224
- References
- 28
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 13 · 2023: 13 · 2022: 5 · 2021: 10 · 2020: 13 · 2019: 8 · 2018: 15 · 2017: 12 · 2016: 16 · 2015: 12 · 2014: 13 · 2013: 9 · 2012: 10
- FWCI
- 4.91
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
- Health Sciences › Medicine › Surgery › Cardiac Structural Anomalies and Repair
- Keywords
- atrial septal defect, long-term outcomes, supraventricular tachyarrhythmias, arrhythmia incidence, pacemaker implantation, stroke, heart failure, pulmonary hypertension, left ventricular dysfunction, right atrial dilatation, exercise capacity, survival, pediatric surgery
- MeSH terms
- Adolescent, Adult, Age Factors, Arrhythmias, Cardiac, Cardiac Output, Low, Child, Child, Preschool, Female, Heart Function Tests, Heart Septal Defects, Atrial, Humans, Infant, Infant, Newborn, Longitudinal Studies, Male, Medical History Taking, Netherlands, Physical Examination, Postoperative Complications, Incidence, Survival Rate, Survival Analysis, Stroke
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