Atrial septal defect post surgical follow up

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3] Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [4]

Overview

Due to the development of new minimally invasive techniques, percutaneous closure and improvement in surgical closure, most patients with atrial septal defect can start eating and ambulating within the first or second postoperative days. Also, most patients with surgical closure are discharged by the third or fourth postoperative days and patients with percutaneous closure, are generally discharged the next day. Surgical follow-up care is mostly for 1-2 months. Ideally, at least 1 follow-up echocardiogram to confirm complete closure of the atrial septal defect should be obtained. A cardiologist with good experience with heart defects should continue patient care. An yearly follow up to monitor development of complications like arrhythmias should be arranged. Six months of aspirin with or without clopidogrel is recommended for prevention of thrombus formation.

2008 ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease (DO NOT EDIT)[1]

2008 ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease (DO NOT EDIT)^[1]

Recommendations for Postintervention Follow-Up (DO NOT EDIT)^[1]

Class I
“1. Early postoperative symptoms of undue fever, fatigue, vomiting, chest pain, or abdominal pain may represent postpericardiotomy syndrome with tamponade and should prompt immediate evaluation with echocardiography. (Level of Evidence: C) ”
“2. Annual clinical follow-up is recommended for patients postoperatively if their ASD was repaired as an adult and the following conditions persist or develop: ”
“a. PAH. (Level of Evidence: C) ”
“b. Atrial arrhythmias. (Level of Evidence: C)”
“c. RV or LV dysfunction. (Level of Evidence: C)”
“d. Coexisting valvular or other cardiac lesions. (Level of Evidence: C)”
“3. Evaluation for possible device migration, erosion, or other complications is recommended for patients 3 months to 1 year after device closure and periodically thereafter. (Level of Evidence: C)”
“4. Device erosion, which may present with chest pain or syncope, should warrant urgent evaluation. (Level of Evidence: C)”

References

↑ ^1.0 ^1.1 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). “ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons”. J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.

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[pmid19038677-1] 1.0 ^1.1 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). “ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons”. J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.

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