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KMID : 0364019770100020268
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Korean Journal of Thoracic and Cardiovascular Surgery
1977 Volume.10 No. 2 p.268 ~ p.273
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Surgical Repair of Secundum Type Atrial Septal Defects Using Extracorporeal Circulation in 48 Patients
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Abstract
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During the period from March, 1963, to November, 1977, forty-eight patients with secundum type atrial septal defects have undergone surgical repair using cardiopulmonary bypass with a pump oxygenator at the Seoul National University Hospital.
Twenty-six (55 percent) of the patients were females and Twenty-two (45 percent) were males. The patients varied in age from 3 years to 51 years.
We have divided secundum defects into three types. These are : 1) the high defect; 2) Ovale type defect; and 3) low defect including the defect in the area of the coronary sinus. An ovale type defect was present in forty-one cases (85% percent). Partial anomalous pulmonary venous connections were present in two patients in the high defect group.
All of the forty-eight patients had had right heart catheterization before operation. The pulmonary to systemic flow ratio (Qp/Qs) was determined in our 38 patients. The Qp/Qs was less than 1.5/1 in only five of the 38 patients. Among the 33 patients with moderate and severe left-to-light shunts (Qp/Qs 1.6-3.5/1), the systolic pulmonary artery pressures ranged from 30 to 80 mm Hg. Large left-to-right shunts (Qp/Qs>3.6/1) were present in 13 patients.
The postoperative complications occured in 13 patients (27.1 percent). Postoperative wound infections were the most frequent complications being present in 6 patients (12.5%).
Forty-six of the patients with secundum atrial septal defects survived surgical repair of their defects. Thus the hospital mortality of surgery was 4.2 percent. The causes of death in the early postoperative period were: 1) low cardiac output syndrome related to severe pulmonary hypertension in one case; and 2) postoperative severa bleeding in one case.
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