RESUMO
BACKGROUND: The aim of the study was to find the factors predictive for paroxysmal atrial fibrillation (AF) following surgical correction of atrial septal defect type II (ASD t.II). METHODS: 93 patients, who underwent isolated surgical closure of ASD t.II between 1990 and 2001 were included. Follow-up studies were performed 2 - 11 years after surgery. Patients were divided into two groups according to the presence of AF before and after surgery. Group AF (+) consisted of 29 and group AF (-) of 64 patients. All patients underwent echocardiography, electrocardiogram (ECG) at rest, and signal-averaged P-wave duration (PWD) in signal-averaged ECG. The following parameters were assessed in echocardiography: pulmonary artery systolic pressure, left and right atrial dimensions, right ventricular dimension, tricuspid and mitral regurgitation. RESULTS: Paroxysmal AF was observed in 27 patients before surgery and in 29 after surgery. Analyzing all potential risk factors we proved that PWD may independently predict occurrence of postoperative AF. CONCLUSION: PWD may independently predict postoperative AF in long-term follow-up after surgical correction of ASD t.II.
Assuntos
Fibrilação Atrial/etiologia , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Comunicação Interatrial/cirurgia , Adulto , Fibrilação Atrial/fisiopatologia , Ecocardiografia , Eletrocardiografia , Feminino , Seguimentos , Comunicação Interatrial/complicações , Comunicação Interatrial/fisiopatologia , Humanos , Masculino , Valor Preditivo dos Testes , Curva ROC , Fatores de Risco , Processamento de Sinais Assistido por Computador , Fatores de TempoRESUMO
In the years 1981-1989 in the Department of Cardiosurgery, Institute of Cardiology, Medical Academy in Lódz, 39 patients with Fallot's syndrome were subjected to radical correction of the congenital heart disease. In 18 cases the correction was preceded by a palliative operation carried out on the average four years before the radical correction of the congenital heart disease. During the early postoperative period seven patients died which accounted for 17%. Out of 39 patients treated surgically, 32 were in I or II haemodynamic grade according to NYHA.
Assuntos
Tetralogia de Fallot/cirurgia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Hemodinâmica/fisiologia , Humanos , Masculino , Cuidados Paliativos , Taxa de Sobrevida , Tetralogia de Fallot/mortalidade , Tetralogia de Fallot/fisiopatologia , Resultado do TratamentoRESUMO
Since the first effective surgical treatment of PAD, the indications for such a treatment have been more extensive and its results and methods have been changing. We present 123 patients who underwent surgery for PAD in the Clinic of Cardiosurgery, Institute of Cardiology, Medical Academy of Lódz within 1978-1987. In 101 cases PAD was dissected and both ends were sutured in two layers with continuous sutures, and in 22 cases PAD was ligated with 3 ligatures. In 30 patients PAD coincided with other congenital defects of the circulatory system. No cases of recanalization were observed in our patients. One death in the postoperative course was noted.
