April 23, 2026Journal of the American College of Cardiology
Resolution of right heart enlargement after closure of secundum atrial septal defect with transcatheter technique11IRB approval and informed consent were both obtained for placement of the Amplatzer Septal Occluder device.
Key result
Transcatheter ASD closure normalizes RV volume at 24 months while RA area remains enlarged.
- P<0.0001
- n=57
Why the study?
Secundum ASD causes right-sided volume overload that may lead to late complications, but little is known about the reduction in right heart size after closure.
Does transcatheter closure of secundum ASD improve right atrial area and right ventricular volume in patients with secundum ASD?
Population
38 patients undergoing transcatheter closure of ASD and 19 control patients
Comparison
Transcatheter ASD closure vs structurally normal hearts
Design
Prospective cohort study
Follow-up
24 months
Authors
Discussion
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Implication
Expect incomplete RA remodeling after transcatheter ASD closure; leaves open whether earlier intervention improves long-term atrial outcomes.
Key Points
- This study aims to evaluate changes in right atrial and ventricular dimensions following ASD closure and identify predictive factors for these changes.
- Prospective evaluation involving 38 patients undergoing transcatheter closure of ASD.
- Transthoracic echocardiography measurements of RA area and RV volume at multiple time points (baseline to 24 months).
- Comparison made with a control group of 19 patients with structurally normal hearts.
- Indexed RA area decreased significantly from baseline to 3-6 months (p = 0.004).
- Indexed RV volume decreased significantly (p < 0.0001) and was similar to control at 24 months (p = 0.3).
- Young age at closure correlated to greater early decrease in RA area (r = 0.55, p = 0.013).
Study Design
Type
Cohort (n=57)
Structured PICO
Does transcatheter closure of secundum ASD improve right atrial area and right ventricular volume in patients with secundum ASD?
P
Population
38 patients undergoing transcatheter closure of secundum atrial septal defect (ASD) and 19 control patients with structurally normal hearts.
I
Intervention
Transcatheter closure of secundum ASD using Amplatzer Septal Occluder device
C
Comparator
Control group of 19 patients with structurally normal hearts
O
Outcome
Reduction in right atrial (RA) area and right ventricular (RV) volume measured by transthoracic echocardiography at 24 hours, 3-6 months, 12 months, and 24 monthssurrogate
Main Result
p-value: p=<0.0001
Transcatheter closure of secundum ASD normalizes right ventricular volume by 24 months, but right atrial area remains enlarged despite significant reduction, with better RA reduction seen in younger patients.
Limitations
- Long-term follow-up is required to evaluate the clinical impact of persistently increased RA size.
- Long-term follow-up is required to evaluate the clinical impact of persistently increased RA size
Cite This Study
Kort et al. (2001) conducted a cohort in Secundum atrial septal defect (n=57). Transcatheter closure of atrial septal defect vs. Control group with structurally normal hearts was evaluated on Reduction in right atrial (RA) area and right ventricular (RV) volume (p=<0.0001). Transcatheter closure of secundum ASD reduced indexed RV volume to levels comparable to normal controls at 24 months (p=0.3), while indexed RA area remained significantly increased (p=0.006).