Combined Atrial Septal Defect Surgical Closure and Irrigated Radiofrequency Ablation in Adult Patients

Abstract

Atrial septal defect (ASD) is one of the most common forms of congenital heart disease found in adults [ 1 x 1 Jemielity, M., Dyszkiewicz, W., Paluszkiewicz, L., Perek, B., Buczkowski, P., and Polizynski, A. Do patients over 40 years of age benefit from surgical closure of atrial septal defects?. Heart. 2001; 85: 300–303 Crossref | PubMed | Google Scholar See all References 1 ]. Atrial arrhythmia, particularly atrial fibrillation (AF) but also atrial flutter and supraventricular tachycardia such as intra-atrial reentry tachycardia, begin to occur frequently in these patients beyond the age of 40 and is a precipitating cause of heart failure [ 2 x 2 Perloff, J.K. Surgical closure of atrial septal defect in adults. N Engl J Med. 1995; 333: 513–514 Crossref | PubMed | Scopus (27) | Google Scholar See all References 2 ]. Surgical closure of ASD in older patients is feasible and is associated with a low mortality rate and a beneficial effect on the clinical status; the occurrence of atrial arrhythmias does not, however, decrease after surgery [ 2 x 2 Perloff, J.K. Surgical closure of atrial septal defect in adults. N Engl J Med. 1995; 333: 513–514 Crossref | PubMed | Scopus (27) | Google Scholar See all References , 3 x 3 Brandenburg, R.O. Jr, Holmes, D.R. Jr, Brandenburg, R.O., and McGoon, D.W. Clinical follow-up study of paroxysmal supraventricular tachyarrhythmias after operative repair of a secundum type atrial septal defect in adults. Am J Cardiol. 1983; 51: 273–276 Abstract | Full Text PDF | PubMed | Scopus (57) | Google Scholar See all References , 4 x 4 Berger, F., Vogel, M., Kramer, A. et al. Incidence of atrial flutter/fibrillation in adults with atrial septal defect before and after surgery. Ann Thorac Surg. 1999; 68: 75–78 Abstract | Full Text | Full Text PDF | PubMed | Scopus (117) | Google Scholar See all References ]. Even after successful closure of the ASD, the risk of a stroke is still high among these patients, and they usually require chronic drug therapy.