Surgery for tricuspid regurgitation associated with ostium secundum atrial septal defects in adults: Three cases

Abstract

Small atrial septal defects are usually asymptomatic and routinely followed in young patients. However, closure of atrial septal defects becomes necessary if defects fail to close or if size of the defects results in hemodynamically significant shunting. Patients with untreated left to right shunting are at risk for long term complications. Including enlargement of right heart structures, tricuspid annular dilatation with secondary valvular insufficiency, and heart failure. Older adult patients may be at risk for paradoxical embolism. Patients are generally referred for surgery before school age. Older patients may be considered for device closure. Nonetheless, in some cases, patients are not diagnosed early or are not followed up sufficiently, leading to progression of disease and discovery in adulthood. We present three adult cases with large atrial septal defects associated with tricuspid valve regurgitation managed surgically.