Hostname: page-component-848d4c4894-x24gv Total loading time: 0 Render date: 2024-06-09T12:15:02.839Z Has data issue: false hasContentIssue false

Echocardiographic and morphological evaluation of the right heart after closure of atrial septal defects

Published online by Cambridge University Press:  01 December 2008

Pin Sun*
Affiliation:
Department of Cardiac Ultrasound, Affiliated Hospital of Medical College, Qingdao University, China
Zhi-Bin Wang
Affiliation:
Department of Cardiac Ultrasound, Affiliated Hospital of Medical College, Qingdao University, China
Chuan-Jin Xu
Affiliation:
Department of Cardiology, Affiliated Hospital of Medical College, Qingdao University, China
Su-Min Yang
Affiliation:
Department of Cardiac Surgery, Affiliated Hospital of Medical College, Qingdao University, China
Lei Jiang
Affiliation:
Department of Cardiac Surgery, Affiliated Hospital of Medical College, Qingdao University, China
*
Correspondence to: Pin Sun, Affiliated Hospital of Medical College, Qingdao University, 16 Jiangsu Road, Qingdao City 266003, Peoples Republic of China. Tel: 86-532-8584-8885; Fax: 86-532-8291-1999; E-mail: sunnysunpin@yahoo.com.cn

Abstract

Objective

To evaluate echocardiographically the function and morphology of the right heart subsequent to transcatheter closure of atrial septal defects.

Methods

We performed echocardiographic studies in 73 patients undergoing transcatheter closure of atrial septal defects 1 day prior to closure, and then 3 days and 3 months after closure. We calculated the antero-posterior diameter of the right ventricle, the transverse diameter and length of the right atrium, the pulmonary arterial pressure, and the velocities of systolic movement and early and late diastolic movement of the basal parietal walls of the right ventricle.

Results

The atrial septal defects varied in size between 8 and 33 millimetres, and were closed using occluders measuring from 10 to 40 millimetres. At 3 days after closure, the antero-posterior diameter of the right ventricle, the transverse diameter and length of the right atrium, the pulmonary arterial pressure, and the velocities of mural motion were all significantly decreased. After 3 months, the size of the right heart had more or less normalized.

Conclusions

Transcatheter closure of atrial septal defects produces marked improvement in the function and geometry of the chambers of the right heart, reducing pulmonary arterial pressure as well as abolishing the interatrial shunt.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Kardon, RE, Sokoloski, MC, Levi, DS, Perry, JS 2nd, Schneider, DJ, Allada, V, Moore, JW. Transthoracic echocardiographic guidance of transcatheter atrial septal defect closure. Am J Cardiol 2004; 94: 256260.CrossRefGoogle ScholarPubMed
2.Cardoso, CO, Rossi Filho, RI, Machado, PR, François, LM, Horowitz, ES, Sarmento-Leite, R. Effectiveness of the Amplatzer device for transcatheter closure of an ostium secundum atrial septal defect. Arq Bras Cardiol 2007; 88: 384389.CrossRefGoogle ScholarPubMed
3.Thomson, JR, Aburawi, EH, Watterson, KG, Van Doorn, C, Gibbs, JL. Surgical and trascathter (Amplatzer) closure of atrial septal defects: a prospect comparison of results and cost. Heart 2002; 87: 466469.CrossRefGoogle Scholar
4.Rosas, M, Attie, F. Atrial septal defect in adults. Timely Top Med Cardiovasc Dis 2007, Dec 13; 11: E34.Google ScholarPubMed
5.Santoro, G, Pascotto, M, Caputo, S, et al. Similar cardiac remodelling after transcatheter atrial septal defect closure in children and young adults. Heart 2006; 92: 958962.CrossRefGoogle ScholarPubMed
6.Jiang, L, Levine, RA, Weyman, AE. Echocardiographic assessment of right ventricular volume and function. Echocardiography 1997; 14: 189206.CrossRefGoogle ScholarPubMed
7.Veldtman, GR, Razack, V, Siu, S, et al. Right ventricular form and function after percutaneous atrial septal defect device closure. J Am Coll Cardiol 2001; 37: 21082113.CrossRefGoogle ScholarPubMed
8.Diab, KA, Cao, QL, Bacha, EA, Hijazi, ZM. Device closure of atrial septal defects with the Amplatzer septal occluder: safety and outcome in infants. J Thorac Cardiovasc Surg 2007; 134: 960966.CrossRefGoogle ScholarPubMed
9.Heusch, A, Rubo, J, Krogmann, ON, Bourgeois, M. Volumetric analysis of the right ventricle in children with congenital heart defects: comparison of biplane angiography and transthoracic dimensional echocardiography. Cardiol Young 1999; 9: 577584.CrossRefGoogle ScholarPubMed
10.Kort, HW, Balzer, DT, Johnson, MC. Resolution of right heart enlargement after closure of secundum atrial septal defect with transcatheter technique. J Am Coll Cardiol 2001; 38: 15281532.CrossRefGoogle ScholarPubMed
11.Carlson, KM, Justino, H, O’Brien, RE, et al. Transcatheter atrial septal defect closure: modified balloon sizing technique to avoid overstretching the defect and oversizing the Amplatzer septal occluder. Cathet Cardiovasc Interv 2005; 66: 390396.CrossRefGoogle ScholarPubMed
12.Fischer, G, Stieh, J, Uebing, A, Hoffmann, U, Morf, G, Kramer, HH. Experience with transcatheter closure of secundum atrial septal defects using the amplatzer septal occluder: a single centre study in 236 consecutive patients. Heart 2003; 89: 199204.CrossRefGoogle ScholarPubMed
13.Pascotto, M, Santoro, G, Cerrato, F, et al. Time-course of cardiac remodeling following transcatheter closure of atrial septal defect. Int J Cardiol 2006; 112: 348352.CrossRefGoogle ScholarPubMed
14.Santoro, G, Pascotto, M, Sarubbi, B, et al. Early electrical and geometric changes after percutaneous closure of large atrial septal defect. Am J Cardiol 2004; 93: 876880.CrossRefGoogle ScholarPubMed