Congenital heart defects in patients above 60 years old: The structure and immediate postoperative results; [Врожденные пороки сердца у пациентов старше 60 лет: структура и непосредственные результаты коррекции]

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. © 2022 Bakoulev National Medical Research Center for Cardiovascular Surgery. All rights reserved.