Abstract
The clinical spectrum of 71 patients with ostium secundum atrial septal defect and the age of more than 40 years old were reviewed and the results were compared with those of 48 younger patients. The number of patients with limited physical activity increased with the advancing age. All but 3 patients under the age of 30 years were classified as NYHA functional class I. The incidences of disabled patients classified as NYHA class III or IV were 11.1% in the fourth decade, 13.3% in the fifth decade, 29.6% in the sixth decade, 45.5% in the seventh decade, respectively. All 3 patients over the age of 70 years were classified as class IV. The cardiothoracic ratio, the right ventricular systolic pressure and echocardiographically determined left atrial dimension correlated positively with the age. Incomplete or complete right bundle branch block was present in 81.2% in younger age group and in 95.0% in older age group. Atrial fibrillation was associated in 9 cases over the age of 50 years. The follow-up results of 47 cases with the age of 40 years or older for more than 2 years were generally favorable. All 14 operated patients were doing well. Six patients without any medical supervision worsened. In spite of medical care, 3 patients died, while 2 patients judged as inoperable worsened.
