Particularities of atrial septal defect in adults treated conservatively and surgically
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CALISTRU, Andrei, CALISTRU, Tamara, CALISTRU, Iulia, PURTEANU, Lilea, GRIB, Andrei. Particularities of atrial septal defect in adults treated conservatively and surgically. In: MedEspera: International Medical Congress for Students and Young Doctors, Ed. 7th edition, 3-5 mai 2018, Chişinău. Chisinau, Republic of Moldova: 2018, 7, pp. 42-43.
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MedEspera
7, 2018
Congresul "International Medical Congress for Students and Young Doctors"
7th edition, Chişinău, Moldova, 3-5 mai 2018

Particularities of atrial septal defect in adults treated conservatively and surgically


Pag. 42-43

Calistru Andrei, Calistru Tamara, Calistru Iulia, Purteanu Lilea, Grib Andrei
 
”Nicolae Testemițanu” State University of Medicine and Pharmacy
 
Disponibil în IBN: 2 noiembrie 2020


Rezumat

Introduction. Atrial septal defect (ASD) represents 13% of congenital heart disease (CHD), with a prevalence of 2 cases per 1000 live births. ASD is often asymptomatic until adulthood, with potential presenting complications: arrthythmias, paradoxical embolization, right atrial (RA) dilatation and right ventricle (RV) dilatation, tricuspid regurgitation, right heart failure and pulmonary hypertension, which can become irreversible and lead to the development of right-to-left shunting (Eisenmenger syndrome). Aim of the study. To study the patients with atrial septal defect treated conservatively and surgically. Materials and methods. The study included 98 patients with ASD, women – 66, men – 44, mean age – 45±4 years, that were examined clinically and paraclinically. The patients with ASD were divided into two groups: group I – surgically treated (57.1%), group II – treated conservatively (42.9%). Results. In 4.2% of cases, ASD was accidentally diagnosed during medical examinations. Clinically, the patients in groups I and II had the following symptoms: dyspnea (35.7% vs 90.5%), palpitations (30.4% vs 64.3%), fatigability (42.9% vs 61.9%), cardialgias (41.1% vs 54.7%), peripheral edema (5.4% vs 11.9%) and haemoptysis in 0% vs 2.4% cases. Echocardiographicaly, in the patients from group I pre- and postoperative sizes of the RA were from 28 mm to 95 mm (average of 58±2 mm) vs 21 - 62 mm (average of 42±4 mm) and in group II – from 34 mm to 72 mm in average being 49±8 mm. The size of the RV in both groups also revealed significant differences: in group I preoperative: 12 - 60 mm (average of 35±9), postoperatively: 15 - 42 mm (average of 28.6 mm) and in group II from 22 - 47 mm (average of 32±6 mm). The pressure in the pulmonary artery in group I, preoperatively was 30 - 85 mmHg (average of 45.7 mmHg), postoperatively: 28 - 65 mmHg (average of 36 mmHg), and in group II: 24 - 75 mmHg with an average of 42±4 mmHg. Complications in patients with ASD pre- and postoperative: heart failure 91.1% vs 15.9%, pulmonary hypertension 92.8% vs 19.6%, arrhythmias 23.2% vs 5.4%, pneumonia 3,6% vs 25%. Medical treatment in patients with ASD operated and not operated consisted from diuretics (23.2% vs 30.9%), beta blockers (12.5% vs 19%), ACE inhibitors (10.7% vs 21.4%), digoxin (0 vs 28.6%) and anticoagulants (5.4% vs 30.9%). Conclusions. Patients with surgically treated ASD showed improvement in clinical manifestations, reduced complications, improved echocardiographical indices, and a decrease in the number of administrated doses comparative to the patients treated conservatively.

Cuvinte-cheie
atrial septal defect, complications, treatment