Late results of mitral cleft closure for ostium primum atrial septal defect in adolescents and adults

Although patients with ostium primum atrial septal defect are believed to develop symptoms relatively early in life, a sizable number may reach adulthood and even early old age with only mild to moderate symptoms. Pericardium, Ivalon sponge, Teflon, and Dacron patches were used to close ostium primum defects with good success in 13 cases treated. No permanent heart block was produced by the operation. No worsening of mitral regurgitation, mitral stenosis, or subaortic stenosis was produced by suture closure of mitral cleft. All mitral clefts should be closed if that is the only valvular pathology present. If the valvular lesion is more extensive, more definitive repair procedures or even valve replacement may be necessary. Persistent apical systolic murmur suggestive of mitral regurgitation was heard in five patients (42%) after the operation. No clinically significant mitral regurgitation was noted in these patients. Echocardiographic evaluation in three patients at 2.5 to 15.5 years after the repair showed normal mitral valve motion. About two years postoperatively in a furth patient, who had operation at the age of 62 yrs, there was mild limitation of motion of the naterior mitral leaflet. Usefulness of echocardiography in evaluating the postoperative status of the repaired mitral valve is emphasized.