Objective To evaluate long-term outcomes of surgical closure of atrial septal defect (ASD) and combined surgical radiofrequency ablation for atrial fibrillation (AF). Methods A total of consecutive 15 patients with ASD undergoing surgical closure of ASD and combined surgical radiofrequency ablation in our department between March 2003 and April 2015. There were 7 males and 8 females at an average age of 47.1±10.8 years ranging from 16 to 62 years. Retrospective analysis and follow-up were performed to evaluate long-term success rate freedom from AF after surgery. Results All patients recovered and discharged, and no patient suffered death or stroke. The duration of follow-up was from 3 to 136 months for all patients. Success rate freedom from AF at 1, 3, 5 and 10 years was 81.3%, 75.0%, 68.8% and 61.1%, respectively. During follow-up, there was no death or stroke. One patient required permanent pacemaker implantation. Conclusion Concomitant surgical closure of ASD and biatrial radiofrequency ablation is safe and effetive with better long-term outcomes. It is necessary to perform the two procedures together for ASD patients.
Objective To summarize the experience with median sternotomy ascending-descending thoracic aortic bypass grafting via median sternotomy for the treatment of complex coarctation of aorta (COA), and to present the intermediate to long-term follow-up outcomes. Methods A retrospective analysis was performed on patients with complex COA who underwent ascending-descending thoracic aortic bypass grafting through a median sternotomy in the First Hospital of Tsinghua University from August 2004 to May 2017. ResultsA total of 7 children were enrolled, including 4 males and 3 females, with an average age of (13.3±4.6) years and an average weight of (40.2±12.2) kg. Six (85.7%) patients had hypertension in the upper limbs. Among them four patients had coarctation associated with intracardiac anomalies, two with recurrent coarctation post-surgery, and one with both recurrent coarctation and intracardiac anomalies. All surgeries were performed under cardiopulmonary bypass, with no operative mortality or severe complications. The systolic pressure gradient between the upper and lower extremities decreased significantly from preoperative (51.4±13.5) mm Hg to postoperative (2.9±2.7) mm Hg (P<0.01). During a follow-up period of (14.9±5.9) years (ranging from 7 to 19 years), there were no late deaths or graft-related complications. Except for one patient who continued to have mild hypertension, the blood pressure of all other patients returned to normal. Conclusion The ascending-descending thoracic aortic bypass grafting via median sternotomy for complex COA is a safe and reliable procedure that effectively reduces upper limb blood pressure and the pressure difference between the upper and lower extremities. It has a low rate of complications and satisfactory intermediate to long-term outcomes.