One hundred consecutive patients, ranging in age from 10 months to 45 years, with a diagnosis of atrial septal defect secundum, were operated on. Of the 100 patients, 38 were asymptomatic, 29 mildly incapacitated, 23 moderately incapacitated, and 10 severely so. Only eight gave a history indicative of congestive cardiac failure. The most prominent complaints were shortness of breath, fatigue, and palpitations (pounding in the chest). Operation was performed under conditions of hypothermia and inflow-outflow occlusion. After the second year of life, the earlier the operation is performed the better. Surgery in a relatively asymptomatic child between the ages of 2 and 10 years carries a minimum of risk and in all probability will insure a normal cardiovascular system when maturity is reached. A high pulmonary vascular resistance increases the risk and decreases the gain that can be anticipated from operation.
Blount SG, Davies DH, Swan H. ATRIAL SEPTAL DEFECT-RESULTS OF SURGICAL CORRECTION IN ONE HUNDRED PATIENTS. JAMA. 1959;169(3):210–213. doi:10.1001/jama.1959.03000200008002
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