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Revista Colombiana de Cardiología

versión impresa ISSN 0120-5633

Resumen

BUCHELI, Víctor et al. Surgical treatment in the management of atrial septal defects. Rev. Colomb. Cardiol. [online]. 2013, vol.20, n.4, pp.246-251. ISSN 0120-5633.

Objective: to describe the epidemiological characteristics and outcomes of surgical treatment of atrial septal defects in patients operated for this condition on a tertiary care center in Colombia. Methods: an observational, descriptive, retrospective study of a cohort including all patients undergoing surgery for atrial septal defects in the period between October 1996 and July 2012. Results: we included a total of 329 patients, were 216 (65.6%) were female. The mean age was 34 years (IQR 15-49). 77.8% of the defects were ostium secundum type. In 80% the defect repair was performed using autologous pericardial patch. In 7.6% of cases we used minimally invasive cardiac surgery technique. Four rescue surgeries (1.21%) were performed due to complications related to the placement of percutaneous devices. We documented only one operative death (mortality rate 0.3%) and an associated overall morbidity of 7.6% without any sequelae and represented by re-operation for bleeding in eight cases (2.4%), deep sternal wound infection in three patients (0.9%), empyema in three patients (0.9%), residual pleural collections in four patients (1.2%), superficial infections in five patients (1.5%), femoral arterial dissection secondary to arterial cannulation in one patient (0.3%) and complete heart block requiring permanent pacemaker in one patient (0.3%). The median length of stay in ICU was 24 hours (IQR 20-25). The median duration of mechanical ventilation was 3 hours (IQR 0-5). The median hospital stay was 4 days (IQR 3-5). Conclusions: the results obtained show that in our environment, surgical correction of atrial septal defects is safe and effective, with a mortality rate tending to 0% and a very low associated morbidity, in line with international standards. Similarly, minimally invasive cardiac surgery has improved the results of the procedure and has been widely accepted by the patients, thus constituting the current preferred approach in the Cardiology service of the institution for the surgical management of this pathology.

Palabras clave : atrial septum; mortality; morbidity; cardiac surgery.

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