What are the factors which can produce right heart failure following ASD surgery?
Age at surgery: The more the age at ASD surgery, the greater the chance of heart failure later. This is related to the extend of pulmonary vascular disease which has already developed prior to surgery. If significant pulmonary vascular disease is present prior to surgery, it may progress even after surgery and lead on the right heart failure.
Atrial flutter: Atrial flutter and other macro reentrant tachycardias can originate in relation to the atrial scar after ASD (atrial septal defect) surgery. Persistent atrial flutter with fast ventricular rate is another cause for delayed heart failure after ASD surgery. It may be amenable to radiofrequency catheter ablation, though 3-D mapping may be needed for better results, unlike in conventional isthmus dependent atrial flutter which can be ablated more easily.
Constrictive pericarditis: Constrictive pericarditis may rarely develop as a post pericardiotomy sequel after ASD surgery as after any other reason for pericardiotomy. This is another cause for development of features suggestive of right heart failure.