Key Points
- To evaluate the impact of atrial septal defect closure on right and left ventricular systolic and diastolic function, and to determine functional differences attributable to cardiopulmonary bypass by comparing surgical and transcatheter approaches.
- Prospective assessment of ventricular long-axis function using cross-sectionally guided M-mode echocardiography before and within one week after intervention.
- Evaluated 17 patients undergoing transcatheter device closure, 12 patients undergoing surgical closure, and 18 healthy normal controls.
- Surgical closure significantly impaired right ventricular indices: total excursion fell by -1.89 cm (95% CI, -2.18 to -1.59), peak shortening rate dropped by -9.09 cm/s (95% CI, -10.82 to -7.35), and peak lengthening rate dropped by -9.26 cm/s (95% CI, -11.09 to -7.43).
- Transcatheter device closure preserved right ventricular total excursion (-0.12 cm; 95% CI, -0.28 to 0.05) and peak lengthening rate (0.01 cm/s; 95% CI, -2.29 to 2.31).
- Left ventricular free wall function was unchanged regardless of closure type, whereas septal function measurements fell across both groups (changes ranging from -3.51 to -0.32; 95% CI ranging from -4.90 to -0.13).
Structured PICO
Does transcatheter device closure preserve right ventricular function compared to surgical closure in patients with atrial septal defects?
PPopulation29 patients with atrial septal defects (ASD) undergoing closure (n=17 device, n=12 surgery) and 18 normal subjects.
IInterventionTranscatheter device closure of atrial septal defect
CComparatorSurgical closure of atrial septal defect
OOutcomeSystolic and diastolic right and left ventricular function measured by cross sectionally guided M mode echocardiographic ventricular long axis function before and within one week after closuresurrogate
Transcatheter closure of ASD preserves right ventricular function, whereas surgical closure impairs it, supporting the transcatheter approach for anatomically suitable defects.