Long-term survival with partial atrioventricular septal defect

Abstract

Long-term survival of patients with partial atrioventricular (AV) septal defect without operative therapy is very rare. We report a 80-year-old female with partial AV septal defect who presented with progressive dyspnea, fatigue and palpitations. A 80-year-old female presented to our clinic complaining of palpitations, dyspnea and decline in general condition. Her history revealed that she had been suffering from paroxysmal palpitations and dyspnea for the last 20 years. The palpitations were usually of short-term duration lasting for a few minutes, though she described a few episodes that lasted longer and necessitated hospital admissions. Her dyspnea had became progressive for the last 2 years (NHYA functional class III). Hermedications were digoxin and amiadorone. The patient's blood pressure was 120/60 mm Hg and pulse rate was 52 beats/min. Auscultation of the heart revealed a 3/6 systolic murmur with maximum intensity at the apex. Lung fields were clear to auscultation. There was no sign of edema and jugular venous distension. Chest X-ray revealed a mild increase in heart size. The ECG showed normal sinus rhythm, first degree AV block, nonspecific intraventricular conduction delay and signs of left ventricular hypertrophy. Holter monitoring showed several bursts of atrial fibrillation. Transthoracic echocardiography (TTE) showed mildly enlarged left atrium, moderate septal hypertrophy, mild calcific aortic stenosis andmoderatemitral regurgitationwith eccentric jet directed toward the lateral and posterior atrium. TTE performed with an apical four-chamber view also disclosed a defect in the inferior part of the interatrial septum with left to