Sinus venosus atrial septal defect: Long-term postoperative outcome for 115 patients

Christine H Attenhofer Jost, Heidi M. Connolly, Gordon K. Danielson, Kent R Bailey, Hartzell V Schaff, Win Kuang Shen, Carole A. Warnes, James B. Seward, Francisco J. Puga, A. Tamil Tajik

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

Background - Sinus venosus atrial septal defect (SVASD) differs from secundum atrial septal defect by its atrial septal location and its association with anomalous pulmonary venous connection (APVC). Data on long-term outcome after surgical repair are limited. Methods and Results - We reviewed outcomes of 115 patients (mean age±SD 34±23 years) with SVASD who had repair from 1972 through 1996. APVC was present in 112 patients (97%). Early mortality was 0.9%. Complete follow-up was obtained for 108 patients (95%) at 144±99 months. Symptomatic improvement was noted in 83 patients (77%), and deterioration was noted in 17 patients (16%). At follow-up, 7 (6%) of 108 patients had sinus node dysfunction, a permanent pacemaker, or both, and 15 (14%) of 108 patients had atrial fibrillation. Older age at repair was predictive of postoperative atrial fibrillation (P=0.033). No reoperations were required during follow-up. Survival was not different from expected for an age- and sex-matched population. Clinical improvement was more common with older age at surgery (P=0.014). Older age at repair (P=0.008) and preoperative New York Heart Association class III or IV (P=0.038) were independent predictors of late mortality. Conclusions - Operation for SVASD is associated with low morbidity and mortality, and postoperative subjective clinical improvement occurs irrespective of age at surgery. Postoperative atrial fibrillation appears to be related to older age at operation. SVASD repair achieves survival similar to that of a matched population and should be considered whenever repair may impact survival or symptoms.

Original languageEnglish (US)
Pages (from-to)1953-1958
Number of pages6
JournalCirculation
Volume112
Issue number13
DOIs
StatePublished - Sep 27 2005

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Atrial Fibrillation
Survival
Mortality
Sick Sinus Syndrome
Lung
Atrial Heart Septal Defects
Atrial Septal Defect Sinus Venosus
Reoperation
Population
Morbidity

Keywords

  • Heart defects, congenital
  • Heart septal defects
  • Surgery
  • Survival

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Sinus venosus atrial septal defect : Long-term postoperative outcome for 115 patients. / Jost, Christine H Attenhofer; Connolly, Heidi M.; Danielson, Gordon K.; Bailey, Kent R; Schaff, Hartzell V; Shen, Win Kuang; Warnes, Carole A.; Seward, James B.; Puga, Francisco J.; Tajik, A. Tamil.

In: Circulation, Vol. 112, No. 13, 27.09.2005, p. 1953-1958.

Research output: Contribution to journalArticle

Jost, CHA, Connolly, HM, Danielson, GK, Bailey, KR, Schaff, HV, Shen, WK, Warnes, CA, Seward, JB, Puga, FJ & Tajik, AT 2005, 'Sinus venosus atrial septal defect: Long-term postoperative outcome for 115 patients', Circulation, vol. 112, no. 13, pp. 1953-1958. https://doi.org/10.1161/CIRCULATIONAHA.104.493775
Jost, Christine H Attenhofer ; Connolly, Heidi M. ; Danielson, Gordon K. ; Bailey, Kent R ; Schaff, Hartzell V ; Shen, Win Kuang ; Warnes, Carole A. ; Seward, James B. ; Puga, Francisco J. ; Tajik, A. Tamil. / Sinus venosus atrial septal defect : Long-term postoperative outcome for 115 patients. In: Circulation. 2005 ; Vol. 112, No. 13. pp. 1953-1958.
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abstract = "Background - Sinus venosus atrial septal defect (SVASD) differs from secundum atrial septal defect by its atrial septal location and its association with anomalous pulmonary venous connection (APVC). Data on long-term outcome after surgical repair are limited. Methods and Results - We reviewed outcomes of 115 patients (mean age±SD 34±23 years) with SVASD who had repair from 1972 through 1996. APVC was present in 112 patients (97{\%}). Early mortality was 0.9{\%}. Complete follow-up was obtained for 108 patients (95{\%}) at 144±99 months. Symptomatic improvement was noted in 83 patients (77{\%}), and deterioration was noted in 17 patients (16{\%}). At follow-up, 7 (6{\%}) of 108 patients had sinus node dysfunction, a permanent pacemaker, or both, and 15 (14{\%}) of 108 patients had atrial fibrillation. Older age at repair was predictive of postoperative atrial fibrillation (P=0.033). No reoperations were required during follow-up. Survival was not different from expected for an age- and sex-matched population. Clinical improvement was more common with older age at surgery (P=0.014). Older age at repair (P=0.008) and preoperative New York Heart Association class III or IV (P=0.038) were independent predictors of late mortality. Conclusions - Operation for SVASD is associated with low morbidity and mortality, and postoperative subjective clinical improvement occurs irrespective of age at surgery. Postoperative atrial fibrillation appears to be related to older age at operation. SVASD repair achieves survival similar to that of a matched population and should be considered whenever repair may impact survival or symptoms.",
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T2 - Long-term postoperative outcome for 115 patients

AU - Jost, Christine H Attenhofer

AU - Connolly, Heidi M.

AU - Danielson, Gordon K.

AU - Bailey, Kent R

AU - Schaff, Hartzell V

AU - Shen, Win Kuang

AU - Warnes, Carole A.

AU - Seward, James B.

AU - Puga, Francisco J.

AU - Tajik, A. Tamil

PY - 2005/9/27

Y1 - 2005/9/27

N2 - Background - Sinus venosus atrial septal defect (SVASD) differs from secundum atrial septal defect by its atrial septal location and its association with anomalous pulmonary venous connection (APVC). Data on long-term outcome after surgical repair are limited. Methods and Results - We reviewed outcomes of 115 patients (mean age±SD 34±23 years) with SVASD who had repair from 1972 through 1996. APVC was present in 112 patients (97%). Early mortality was 0.9%. Complete follow-up was obtained for 108 patients (95%) at 144±99 months. Symptomatic improvement was noted in 83 patients (77%), and deterioration was noted in 17 patients (16%). At follow-up, 7 (6%) of 108 patients had sinus node dysfunction, a permanent pacemaker, or both, and 15 (14%) of 108 patients had atrial fibrillation. Older age at repair was predictive of postoperative atrial fibrillation (P=0.033). No reoperations were required during follow-up. Survival was not different from expected for an age- and sex-matched population. Clinical improvement was more common with older age at surgery (P=0.014). Older age at repair (P=0.008) and preoperative New York Heart Association class III or IV (P=0.038) were independent predictors of late mortality. Conclusions - Operation for SVASD is associated with low morbidity and mortality, and postoperative subjective clinical improvement occurs irrespective of age at surgery. Postoperative atrial fibrillation appears to be related to older age at operation. SVASD repair achieves survival similar to that of a matched population and should be considered whenever repair may impact survival or symptoms.

AB - Background - Sinus venosus atrial septal defect (SVASD) differs from secundum atrial septal defect by its atrial septal location and its association with anomalous pulmonary venous connection (APVC). Data on long-term outcome after surgical repair are limited. Methods and Results - We reviewed outcomes of 115 patients (mean age±SD 34±23 years) with SVASD who had repair from 1972 through 1996. APVC was present in 112 patients (97%). Early mortality was 0.9%. Complete follow-up was obtained for 108 patients (95%) at 144±99 months. Symptomatic improvement was noted in 83 patients (77%), and deterioration was noted in 17 patients (16%). At follow-up, 7 (6%) of 108 patients had sinus node dysfunction, a permanent pacemaker, or both, and 15 (14%) of 108 patients had atrial fibrillation. Older age at repair was predictive of postoperative atrial fibrillation (P=0.033). No reoperations were required during follow-up. Survival was not different from expected for an age- and sex-matched population. Clinical improvement was more common with older age at surgery (P=0.014). Older age at repair (P=0.008) and preoperative New York Heart Association class III or IV (P=0.038) were independent predictors of late mortality. Conclusions - Operation for SVASD is associated with low morbidity and mortality, and postoperative subjective clinical improvement occurs irrespective of age at surgery. Postoperative atrial fibrillation appears to be related to older age at operation. SVASD repair achieves survival similar to that of a matched population and should be considered whenever repair may impact survival or symptoms.

KW - Heart defects, congenital

KW - Heart septal defects

KW - Surgery

KW - Survival

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