Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands,
Neth Heart J. 2015 Apr;23(4):205-11. doi: 10.1007/s12471-015-0663-z.
Secundum atrial septal defect (ASDII) is a common congenital heart defect that causes shunting of blood between the systemic and pulmonary circulations. Patients with an isolated ASDII often remain asymptomatic during childhood and adolescence. If the defect remains untreated, however, the rates of exercise intolerance, supraventricular arrhythmias, right ventricular dysfunction and pulmonary arterial hypertension (PAH) increase with patient age, and life expectancy is reduced. Transcatheter and surgical techniques both provide valid options for ASDII closure, the former being the preferred method. With the exception of those with severe and irreversible PAH, closure is beneficial to, and thus indicated in all patients with significant shunts, regardless of age and symptoms. The symptomatic and survival benefits conferred by defect closure are inversely related to patient age and the presence of PAH, supporting timely closure after diagnosis. In this paper we review the management of adult patients with an isolated ASDII, with a focus on aspects of importance to the decision regarding defect closure and medical follow-up.
继发房间隔缺损（ASDII）是一种常见的先天性心脏病，可导致体循环和肺循环之间血液分流。患有孤立性 ASDII 的患者在儿童期和青春期通常无症状。然而，如果不进行治疗，随着患者年龄的增长，运动耐量降低、室上性心律失常、右心室功能障碍和肺动脉高压（PAH）的发生率会增加，预期寿命会缩短。经导管和手术技术均可为 ASDII 关闭提供有效选择，前者是首选方法。除了那些患有严重和不可逆转的 PAH 的患者外，对于所有存在明显分流的患者，无论年龄和症状如何，关闭都是有益的，因此都是适应证。缺损关闭带来的症状和生存获益与患者年龄和 PAH 的存在呈反比，支持在诊断后及时进行关闭。本文回顾了孤立性 ASDII 成年患者的管理，重点介绍了与缺损关闭和医学随访决策相关的重要方面。
