Outcomes of mitral regurgitation after surgery for large atrial septal defects
10.3760/cma.j.cn341190-20250108-00045
- VernacularTitle:大缺损型房间隔缺损术后二尖瓣反流转归的研究
- Author:
Xiaopu WANG
1
;
Jinguo XU
1
;
Chengxin ZHANG
1
;
Shenglin GE
1
Author Information
1. 安徽医科大学第一附属医院心脏大血管外科，合肥 230022
- Publication Type:Journal Article
- Keywords:
Heart septal defects, atrial;
Mitral valve insufficiency;
Heart defects, Congenital;
Hypertension, pulmonary;
Echocardiography, stress;
Follow-up studies
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(8):1159-1163
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the changes in the severity of mitral regurgitation in patients with large atrial septal defects after surgery.Methods:This study conducted a retrospective analysis using a self-controlled method on 145 patients with secundum atrial septal defects greater than 2 cm who underwent surgical treatment in the Department of Cardiology and Macrovascular Surgery at The First Affiliated Hospital of Anhui Medical University from January 2021 to October 2023. Among these patients, 74 underwent surgical closure, while 71 underwent surgical repair. Data including general information, defect size, number of surgeries of various types, preoperative transthoracic echocardiogram results, and follow-up results from the first and most recent transthoracic echocardiograms after discharge for all patients were collected. The Friedman test was used to compare the degree of mitral regurgitation before surgery and at the first and most recent follow-up after discharge. The differences in the severity of mitral regurgitation in patients before and after surgical treatment were analyzed.Results:Among the 145 patients, there were 25 males and 110 females, with an average age of (36 ± 14) years, height of (163.4 ± 8.2) cm, and body weight of (59.5 ± 10.5) kg. The diameter of the defect was (2.49 ± 0.35) cm. Before surgery, the severity of mitral regurgitation was classified as none, mild, and moderate (including mild to moderate) for 57 patients (39.3%), 83 patients (57.2%), and 5 patients (3.4%), respectively. The average follow-up duration was (324 ± 153) days. At the first follow-up after discharge, the severity of mitral regurgitation was none, mild, and moderate for 50 patients (34.5%), 87 patients (60.0%), and 8 patients (5.5%), respectively. At the most recent follow-up after discharge, the severity of mitral regurgitation was none, mild, and moderate for 30 patients (20.7%), 89 patients (61.4%), and 26 patients (17.9%), respectively. Compared with the preoperative severity of mitral regurgitation, the most recent follow-up showed worsening in 65 patients (44.8%) and improvement in 22 patients (15.2%). The mean rank sums for the three degrees of mitral regurgitation were 1.83, 1.91, and 2.26, with a statistically significant difference ( χ2 = 25.36, P = 0.001). Pairwise comparisons indicated that the most recent follow-up after discharge showed worsening compared with the preoperative severity of mitral regurgitation ( P < 0.05) and that it also worsened compared with the first follow-up after discharge ( P < 0.05). Conclusions:In patients with secundum atrial septal defects greater than 2 cm, undergoing surgery solely for atrial septal defects may result in the potential worsening of mitral regurgitation after the procedure.
