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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

View larger version (105K): [in a new window]   Figure 1 Spectral Doppler recordings of tricuspid regurgitation jet (A), right ventricular outflow (B), mitral inflow (C), and left ventricular outflow (D) in a patient with previous device closure of a secundum atrial septal defect. Intervals a and b are used to calculate myocardial performance index (MPI) for the right and left ventricle as per the formula: MPI = (a – b)/b. bpm = beats/min; CW = continuous-wave Doppler; HR = heart rate; PW = pulsed-wave Doppler.

View larger version (61K): [in a new window]   Figure 2 Two-dimensional echocardiograms from parasternal long-axis (A), short-axis (B), and apical four-chamber (C) views at ventricular end-systole, displaying the measurements required for estimation of left atrial volume (LAV) using the length-diameter ellipsoid method. bpm = beats per minute; D1 = left atrial (LA) anteroposterior; D2 = LA medial-lateral diameter; HR = heart rate; L = LA long-axis length.

View larger version (26K): [in a new window]   Figure 3 Right ventricular (RV) and left ventricular (LV) myocardial performance indexes (mean and 95% confidence intervals [CI]) before (pre) and after (post) transcatheter closure of atrial septal defect.

View larger version (15K): [in a new window]   Figure 4 Left atrial volume index (mean and 95% confidence intervals [CI]) shown before (pre) and after (post) device closure of atrial septal defect (ASD).