老年人先天性房间隔缺损外科治疗的体会

目的总结老年人房间隔缺损的手术及术后处理方法。方法对31例60～66岁继发孔型房间隔缺损患者进行手术治疗，19例同期处理三尖瓣病变，8例同期行射频消融治疗心房颤动（房颤），并与59例45～59岁的非老年患者比较，观察手术疗效。结果两组患者手术后全部存活，老年组8例行射频消融术，有效率87．5％，右心功能不全8例，治疗后好转；非老年组8例行射频消融术，有效率100．0％，右心功能不全2例，治疗后好转。结论年龄不是房间隔缺损手术的禁忌证，正确的术后处理、并存症的治疗和房颤治疗对预后有重要影响。

Surgical treatment of congenital atrial septal defect in the elderly

Objective To evaluate the results and clinical experience of surgical repair of congenital atrial septal defect (ASD) in patients aged 60 years and over. Methods Surgical treatment was performed on 31 elderly patients with congenital atrial septal defect. Among them, atrial fibrillation in 8 cases and tricuspid disease in 19 cases were treated during the operation, and the data were compared with those of 59 non-elderly patients. Results All the patients survived. In the elderly group, 8 cases had atrial fibrillation which underwent radiofrequency ablation. 3 months relapse rate atrial fibrillation was 12. 5%, and right heart dysfunction in 8 cases was improved after toperation. Conclusions Old age is not a contradiction to surgical repair of atrial septal defect. The key element in successful operation relies on optimal postoperative treatment strategy, concomitant correction of the coexisted disease and atrial fibrillation.