Original article
Atrial Function After Surgical and Percutaneous Closure of Atrial Septal Defect: A Strain Rate Imaging Study

https://doi.org/10.1016/j.echo.2005.01.029Get rights and content

The effect of operation and the effect of the imposition of an occluding device on atrial function for patients with an atrial septal defect (ASD) has never been studied. Thus, the aim of this study was to evaluate for the first time both left atrial (LA) and right atrial (RA) function of children after transcatheter ASD closure with that of sex- and age-matched patients with surgically treated ASD, and sex- and age-matched control subjects using strain (ϵ) and ϵ rate imaging (SR). In all, 45 participants formed our studied sample: 15 patients after successful ASD device closure (ASD-D [atrial septal defect device closure] group, mean age: 9 ± 3 years) and 15 age- and sex-matched patients after successful ASD surgical closure (ASD-S [atrial septal defect surgical closure] group, mean age: 9 ± 3 years). All patients underwent ASD correction at least 6 months before the study. As a control group we selected 15 age- and sex-matched control subjects. In the ASD-S group the peak systolic ϵ and SR values were significantly reduced in both RA and LA when compared with control and ASD-D groups (P < .01). In the ASD-D group there was no significant difference in both LA and RA deformation properties when compared with control subjects. SR imaging indexes could provide new, noninvasive, clinically relevant insight on regional changes in atrial function for patients with ASD. ASD percutaneous closure is useful not only because it is less expensive and invasive than open-heart operation but also for its conservation of both LA and RA regional myocardial properties.

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Participants

In all, 45 participants formed our studied sample. We enrolled 15 patients after successful ASD device closure (ASD-D group, mean age: 9 ± 3 years; 4 boys) and 15 age- and sex-matched patients after successful ASD surgical closure (ASD-S group, mean age: 9 ± 3 years; 4 boys). All patients underwent ASD correction at least 6 months before the study (ASD-D [atrial septal defect device closure] group: range 6-48 months, median 12 months; ASD-S [atrial septal defect surgical closure] group: range

Results

Clinical and standard echocardiographic characteristics of the studied sample are listed in Table 1.

The age at ASD repair and the ASD diameter were comparable between patient groups.

Right ventricular end-diastolic dimension for patients with ASD-S was significantly larger than in control subjects and patients with ASD-D.

Standard transmitral and transtricuspid flow Doppler evaluation was similar among groups.

Discussion

This is the first attempt to study atrial function for patients after successful ASD closure. Our results demonstrate that percutaneous ASD closure preserves both RA and LA deformation properties.

Despite the successful surgical closure of an ASD, the incidence of atrial arrhythmias in these patients is high.15 This has been attributed to electrophysiologic abnormalities related to the age at the time of surgical repair, and the pulmonary arterial pressure.1, 2, 15

So far, no studies are

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