CLINICAL RESEARCH: MINI-FOCUS: TRANSCATHETER CLOSURE OF ASD AND PFO
Improvements in cardiac form and function after transcatheter closure of secundum atrial septal defects
Omid Salehian, MD, MSc, FRCPC*,
Eric Horlick, MD, FRCPC*,
Markus Schwerzmann, MD*,
Kim Haberer, BArt, Sc, MA*,
Peter McLaughlin, MD, FRCPC*,
Samuel C. Siu, MD, SM, FRCPC, FACC*, ,
Gary Webb, MD, FRCPC, FACC* and
Judith Therrien, MD, FRCPC,*, ,*
* Toronto Congenital Center for Adults and Echocardiography Laboratory
Division of Cardiology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
Adult Congenital Heart Center, Division of Cardiology, Department of Medicine, Sir MB Davis Jewish General Hospital, McGill University, Montreal, Quebec, Canada
Manuscript received July 29, 2004;
revised manuscript received October 16, 2004,
accepted October 25, 2004.
* Reprint requests and correspondence: Dr. Judith Therrien, Sir MB Davis Jewish General Hospital, 3755 Cote Ste. Catherine, Montreal, Quebec, Canada, H3T 1E2 (Email: jtherrien{at}cardio.jgh.mcgill.ca).
OBJECTIVES: We set out to study the effect of transcatheter closure of atrial septal defect (ASD) on right ventricular (RV) and left ventricular (LV) function assessed by myocardial performance index (MPI), as well as left atrial (LA) volumes.
BACKGROUND: The hemodynamic response to the closure of ASD is well-documented in surgically treated patients. However, few studies have documented echocardiographic evaluation of ventricular function in patients undergoing transcatheter closure of ASDs.
METHODS: Pre- and post-ASD device closure echocardiograms of 25 consecutive patients were retrospectively reviewed. Measurements of RV and LV MPI and LA volumes were made.
RESULTS: Twenty-five patients with an average age of 45.5 ± 16.3 years underwent transcatheter closure of ASD. There was statistically significant improvement in RV MPI (0.35 to 0.28, p = 0.004), LV MPI (0.37 to 0.31, p = 0.04), and LA volume index (25.7 to 21.8 ml/m2, p < 0.001) after closure of ASD.
CONCLUSIONS: Device closure of ASDs leads to improvement of both RV and LV function as well as reduction in LA volume. These hemodynamic improvements provide insights into the symptomatic benefits gained in closure of ASDs using the transcatheter approach.
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Abbreviations and Acronyms
| | ASD = atrial septal defect | | EF = ejection fraction | | IVRT = isovolumic relaxation time | | LA = left atrial/atrium | | LAVI = left atrial volume index | | LV = left ventricle/ventricular | | LVEDD = left ventricular end-diastolic diameter | | LVESD = left ventricular end-systolic diameter | | MPI = myocardial performance index | | RV = right ventricle/ventricular |
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