Congenital heart defects in patients above 60 years old: the structure and immediate postoperative results

Authors: Podzolkov V.P., Minaev A.V., Chiaureli M.R., Kovalev D.V., Serguladze S.Yu., Golubev E.P., Tsokova A.O., Zemlyanskaya I.V., Sabirov B.N., Mwela B.M.

Company: 1 Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation
2 Peoples Friendship University of Russia, Moscow

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2022-16-1-92-101

For citation: Podzolkov V.P., Minaev A.V., Chiaureli M.R., Kovalev D.V., Serguladze S.Yu., Golubev E.P., Tsokova A.O., Zemlyanskaya I.V., Sabirov B.N., Mwela B.M. Congenital heart defects in patients above 60 years old: the structure and immediate postoperative results. Creative Cardiology. 2022; 16 (1): 92–101 (in Russ.). DOI: 10.24022/1997-3187-2022-16-1-92-101

Received / Accepted:  25.11.2021 / 24.03.2022

Keywords: congenital heart defects in adults atrial septal defect ventricular septal defect atrial fibrillation

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Abstract

Objective. To present the structure of congenital heart defects (CHD), the algorithm for their diagnosis, the possible stages of treatment, and the immediate results of post-operative correction in elderly patients.

Material and methods. The study included 77 patients who were operated on for CHD aged between 60 to 75 years old, over the period from 2008 to 2021. The congenital heart defects were as follows: secondary atrial septal defects 51 (66%) patients, partial anomalous pulmonary venous return 12 (16%), patent ductus arteriosus 7 (9%), ventricular septal defect 4 (5%), pulmonary artery stenosis 2 (3%), corrected transposition of the great vessels with a permanent atrial flutter 1 (1%). Pulmonary hypertension stage I–II was noted in 64% of cases. various forms of atrial fibrillation were detected in 34% of cases. Other diseases (of the gastrointestinal tract, respiratory system, kidneys, etc.) were noted in 78% of cases. Open heart surgery was performed in 45 patients (58% of cases) with conditions needing artificial circulation, endovascular procedures – 31 patients (40% of cases), electrical cardiac stimulation implant – 1 patient (1% of cases). The most commonly performed interventions were tricuspid valve repair (n = 22), radiofrequency ablation (n = 11), mitral valve repair (n = 4), coronary artery bypass grafting (n = 4).

Results. There were no lethal cases. After open-heart surgery, the most common complications were heart failure, respiratory failure, and heart rhythm disturbances (in 18% of cases). After endovascular correction, 1 patient developed heart rhythm disturbances (3%).

Conclusion. Congenital heart defects in the elderly is most often represented by defects with arteriovenous shunting and secondary hemodynamic disorders. The correction of congenital heart defects in this group resulted in good immediate results and the absence of hospital mortalities.

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About Authors

  • Vladimir P. Podzolkov, Dr. Med. Sci., Professor, Academician of RAS, Head of Department, Deputy Director; ORCID
  • Anton V. Minaev, Cand. Med. Sci., Senior Researcher; ORCID
  • Mikhail R. Chiaureli, Dr. Med. Sci., Professor, Deputy Head of Department, Chief Researcher; ORCID
  • Dmitriy V. Kovalev, Dr. Med. Sci., Leading Researcher; ORCID
  • Sergey Yu. Serguladze, Dr. Med. Sci., Head of Department; ORCID
  • Evgene P. Golubev, Cand. Med. Sci., Cardiac Surgeon; ORCID
  • Alana O. Tsokova, Cardiologist; ORCID
  • Inga V. Zemlyanskaya, Dr. Med. Sci., Leading Researcher; ORCID
  • Bokhodir N. Sabirov, Dr. Med. Sci., Leading Researcher; ORCID
  • Bupe M. Mwela, Postgraduate; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery