Percutaneous device closure of atrial septal defect results in very early and sustained changes of right and left heart function

An Experience of a Tertiary Center for 9 Years on Patients with Surgical and Percutaneous Closure of Atrial Septal Defects

“…Right ventricle dilatation before closure, directly septal slip from right to left and indirectly through the pericardium, restricts both LV size and filling. Thilen et al [14] and Monfredi et al [15] shown that post-procedural LV diastolic diameters and LV fractional shortening increase in both surgical and percutaneous closure patients [14,15]. Consistent with these study results above, we observed a significant increase in LV diameters after surgery in both our surgical and percutaneous closure groups (Table 3).…”

“…RV remodelling begins within 24 hours after percutaneous closure and lasts for 6-8 weeks. Trees et al [14] observed a decrease in the size of the right heart cavities after percutaneous closure [14]. In surgical studies, it has been found that the surgeon often fails to normalize the cardiac geometry [15].…”

Both Systemic and Pulmonary Artery Stiffness Predict Ventricular Functional Recovery after Successful Percutaneous Closure of Atrial Septal Defects in Adults

“…21,22 Although 2D-MPI has been investigated in patients with corrected CHD and found controversial results, the effect of transcatheter closure of ASD on LV and RV TD-MPI is not well established. 4,9,10 The main advantage of TD imaging in CHD is that; the method is suitable to be applied to any chamber morphology, as the variables are not affected by chamber geometry. Yasuoka et al demonstrated that although pulsed Doppler MPI values in patients with tetralogy of Fallot did not differ from normal subjects, TD-MPI was significantly greater in patients with tetralogy of Fallot.…”

Right Ventricular Outflow Tract (RVOT) Changes in Children with an Atrial Septal Defect: Focus on RVOT Velocity Time Integral, RVOT Diameter, and RVOT Systolic Excursion

“…While most patients with secundum ASD are initially free from overt symptoms, many become symptomatic in later adult life due to chronic right heart volume overload . Right ventricular (RV) and right atrial (RA) enlargement, together with other echocardiographic variables, has been shown to be relevant parameters in adults for the determination of the hemodynamic relevance of an ASD . In adults, recent guidelines for assessment of the right heart endorsed by the American and European Societies of Echocardiography recommend the measurement of the RV outflow tract (RVOT) diameter as part of the standard echo examination.…”

“…2 Right ventricular (RV) and right atrial (RA) enlargement, together with other echocardiographic variables, has been shown to be relevant parameters in adults for the determination of the hemodynamic relevance of an ASD. 3,4 In adults, recent guidelines for assessment of the right heart endorsed by the American and European Societies of Echocardiography 5 recommend the measurement of the RV outflow tract (RVOT) diameter as part of the standard echo examination. To date, it is still unclear whether right heart volume overload due to the shunt at atrial level also influences the RVOT size and systolic function in children.…”