{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:11:27Z","timestamp":1791828687439,"version":"4.3.4"},"reference-count":17,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"accepted":{"date-parts":[[2000,9,11]]},"published-print":{"date-parts":[[2001,3,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To determine the value of surgical closure of atrial septal defects in patients over 40 years of age.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec sec-type=\"methods\">\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Retrospective analysis of 76 patients (63 women, 13 men), age range 40\u201362 years (mean (SD) 45.8 (5.1) years), who underwent surgical repair of atrial septal defect. Pre- and postoperative clinical status (New York Heart Association (NYHA) functional class) was assessed, and ECG,<jats:italic>x<\/jats:italic> ray, and echocardiographic investigations performed. Follow up was between 1 and 17 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>One operative and one late death occurred during the study period. Before operation, 47 patients (61.8%) were in NYHA functional classes III and IV. After operation, 61 patients (82.4%) were in classes I and II. Four patients had atrial fibrillation before surgery versus nine after surgery. Before operation, 52 patients had intensified pulmonary vascularity compared with only seven after operation. Echocardiographic examination showed a significant reduction in right ventricular dimension (4.10 (0.91)<jats:italic>v<\/jats:italic> 2.95 (0.36)\u2009cm, p\u2009&lt;\u20090.001). No residual intracardiac shunts were identified on echocardiographic follow up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Surgical closure of atrial septal defects in patients over 40 years old can improve their clinical status and prevent right ventricular dilatation and insufficiency.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/heart.85.3.300","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T06:37:59Z","timestamp":1027751879000},"page":"300-303","source":"Crossref","is-referenced-by-count":38,"title":["Do patients over 40 years of age benefit from surgical closure of atrial septal defects?"],"prefix":"10.1136","volume":"85","author":[{"given":"M","family":"Jemielity","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Institute of Cardiology, Karol Marcinkowski University of Medical Sciences, Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Dyszkiewicz","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Institute of Cardiology, Karol Marcinkowski University of Medical Sciences, Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Paluszkiewicz","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Institute of Cardiology, Karol Marcinkowski University of Medical Sciences, Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Perek","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Institute of Cardiology, Karol Marcinkowski University of Medical Sciences, Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Buczkowski","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Institute of Cardiology, Karol Marcinkowski University of Medical Sciences, Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Poniz\u02d9y\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Institute of Cardiology, Karol Marcinkowski University of Medical Sciences, Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2001,3,1]]},"reference":[{"key":"2025091923052607000_85.3.300.1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(73)90803-5"},{"key":"2025091923052607000_85.3.300.2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1988.01400320051010"},{"key":"2025091923052607000_85.3.300.3","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.32.6.820"},{"key":"2025091923052607000_85.3.300.4","doi-asserted-by":"publisher","DOI":"10.1007\/BF01649286"},{"key":"2025091923052607000_85.3.300.5","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1378\/chest.104.4.1075","article-title":"Unusual clinical presentations of secundum atrial septal defect.","volume":"104","author":"Fahmy","year":"1993","journal-title":"Chest"},{"key":"2025091923052607000_85.3.300.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199508243330801"},{"key":"2025091923052607000_85.3.300.7","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.71.3.224"},{"key":"2025091923052607000_85.3.300.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199012133232401"},{"key":"2025091923052607000_85.3.300.9","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/BF00422947","article-title":"The natural course of atrial septal defect in adults\u2014a still unsettled issue.","volume":"70","author":"Cheng","year":"1992","journal-title":"Clin Invest"},{"key":"2025091923052607000_85.3.300.10","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.71.3.219"},{"key":"2025091923052607000_85.3.300.11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199508243330809"},{"key":"2025091923052607000_85.3.300.12","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1161\/01.CIR.37.2.261","article-title":"Atrial septal defect in patients over the age of forty years.","volume":"37","author":"Gault","year":"1968","journal-title":"Circulation"},{"key":"2025091923052607000_85.3.300.13","doi-asserted-by":"publisher","DOI":"10.1136\/thx.24.5.536"},{"key":"2025091923052607000_85.3.300.14","doi-asserted-by":"publisher","DOI":"10.1136\/thx.27.5.577"},{"key":"2025091923052607000_85.3.300.15","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1097\/00000658-197405000-00036","article-title":"The adult atrial septal defect: results of surgical repair.","volume":"179","author":"Hairston","year":"1974","journal-title":"Ann Surg"},{"key":"2025091923052607000_85.3.300.16","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.64.2.402"},{"key":"2025091923052607000_85.3.300.17","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(96)00395-5"}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/heart.85.3.300","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T06:05:35Z","timestamp":1758348335000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/heart.85.3.300"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,3,1]]},"references-count":17,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2001,3,1]]},"published-print":{"date-parts":[[2001,3,1]]}},"alternative-id":["10.1136\/heart.85.3.300"],"URL":"https:\/\/doi.org\/10.1136\/heart.85.3.300","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"value":"1355-6037","type":"print"},{"value":"1468-201X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,3,1]]}}}