Key result
Transcatheter closure of ASD secundum significantly improved biventricular reverse remodeling, reducing the 3D end-systolic RV:LV ratio from 1.9 at 24 hours to 1.6 at 1 month post-procedure.
Why the study?
To evaluate the role of 3D echocardiography in diagnosing MVP and to examine the relationship between biventricular reverse remodeling and MVP following transcatheter ASD secundum closure.
Does 3D echocardiography improve the detection of mitral valve prolapse and biventricular reverse remodeling compared to 2D echocardiography in patients after transcatheter closure of ASD secundum?
Cohort (n=60)
Yes
Does 3D echocardiography improve the detection of mitral valve prolapse and biventricular reverse remodeling compared to 2D echocardiography in patients after transcatheter closure of ASD secundum?
3D echocardiography is more accurate than 2D echocardiography in detecting mitral valve prolapse and early biventricular reverse remodeling following transcatheter closure of secundum atrial septal defects.
Answers are grounded in this paper and cite their sources.
Supports 3D echocardiography for post-ASD closure remodeling assessment; leaves open randomized validation versus 2D.
Introduction: Mitral valve prolapse (MVP) is the most common anomaly of the mitral valve. Several studies have shown prevalence of MVP in atrial septal defect (ASD) especially secundum types (II). The aims of this study is to show the potential role of 3D echocardiography in improving the diagnosis of MVP and to depict the relationship between reverse remodeling of the right and left ventricles (RV, LV) and MVP after transcatheter closure of ASD II. Methods: Sixty patients underwent transcatheter closure of ASD II and completed follow up by 2D and 3D echocardiography in Cairo University Children Hospital before the procedure and at 24 hours, 1 and 6 months after the procedure. Results: 3D echocardiography was more accurate than 2D echocardiography in detecting MVP frequency in ASD II patients (75% vs. 50%). Maximum statistically significant remodeling was detected by 3D echocardiography 1 month after the procedure (RV: LV ratio by 3D echocardiography 1.9±0.03 24 hours after the procedure vs. 1.6±0.03 1 months after the procedure, P <0.01) while 2D echocardiography was delayed in detecting biventricular reverse remodeling. 3D derived RV: LV ratio was accurate in detecting MVP status with a sensitivity of 88%. Conclusion: MVP in ASD II may be related to Biventricular remodeling; 3D echocardiography is accurate in the detection of reverse remodeling as well as MVP in ASD II patients before and after device closure.
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El-Sisi et al. (2019) conducted a cohort in Atrial septal defect (ASD) secundum (n=60). Transcatheter closure of ASD type II vs. 24 hours post-procedure was evaluated on 3D end-systolic RV:LV ratio at 1 month vs 24 hours post-procedure (p=<0.01). Transcatheter closure of ASD secundum significantly improved biventricular reverse remodeling, reducing the 3D end-systolic RV:LV ratio from 1.9 at 24 hours to 1.6 at 1 month post-procedure.
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