Atrial Septal Defect Closure in Geriatric Patients

The prevalence of adults with congenital heart disease is rising in the general population (1). Similarly, the number of geriatric patients with congenital heart disease, such older than 70 years old, is also rising. Furthermore, mortality rates in congenital heart disease have shifted away from the young and towards adults, with a steady increase in age at death. Actually, the mortality of congenital heart disease in patients whose age 60 years or more is increasing during past few decades reported in Japanese nationwide survey (2). Atrial septal defect (ASD) is the one of the most common congenital heart lesions in adults, and the most influenced heart disease for the death in geriatric population. Prevalence of ASD in children is noted to be 11.4% within the congenital heart defects (3). Majority of these children are asymptomatic and diagnosed by school physical examination, heart murmur detected primary care pediatrician, cardiac echo screening in the newborn period. If defect is smaller than 6 mm, spontaneous closure can be expected. Operation is scheduled based on children’s body size, usually before the elementally school with very low incidence of mortality rate (4).