Key result
Transcatheter closure of large ASDs in children significantly improved LV peak basal clockwise rotation from -6.9° to -10.3° (P=0.005) and LV twist from 11.3° to 17.5° (P=0.001) at 24 hours.
Why the study?
Large ASDs cause RV volume overload leading to impaired LV performance, and the immediate effects of device closure and volume overload removal on LV rotational deformation required evaluation.
Does transcatheter closure of large secundum ASDs improve immediate left ventricular rotational deformation in children?
Observational (n=20)
Does transcatheter closure of large secundum ASDs improve immediate left ventricular rotational deformation in children?
Transcatheter closure of large secundum ASDs in children leads to immediate improvement in left ventricular twisting and torsion, primarily due to improved peak systolic clockwise basal rotation.
Supports immediate LV rotational recovery after large ASD closure in children; leaves open durability and clinical relevance.
BACKGROUND: Large atrial septal defects (ASDs) in children cause increased volume overload of the right side of the heart which in turn lead to impairment of left ventricular (LV) performance. AIM: The aim of this study was to evaluate immediate LV rotational deformation changes in children with large ASDs post-device closure and removal of right ventricle (RV) volume overload. PATIENTS AND METHODS: Twenty children who underwent transcatheter closure (TCC) of large secundum ASDs were included in the study. LV rotational deformation was assessed pre- and 24 hours post-device closure using speckle tracking imaging (STI). RESULTS: 55% were females with mean age 6.1 ± 3.5 years. LV peak basal clockwise rotation improved significantly (-6.9 ± 2.6° before vs -10.3 ± 4.1° after TCC, P = .005), and time to peak clockwise rotation (345.1 ± 124.7 milliseconds (ms) before vs 282.2 ± 82.9 ms after closure, P = .02). There was no significant difference in apical rotational parameters including peak counterclockwise rotation (P > .05 for both). LV twist (11.3 ± 3.8° before vs 17.5 ± 7.1° after closure, P = .001) and torsion (2.1 ± 0.7°/cm before vs 3.1 ± 1.2°/cm after closure, P = .01) were significantly improved, mainly as the result of improvement of LV basal rotation. LV revealed a significant increase in LV end-diastolic volumes (P = .02) 24 hour after TCC with no significant change (P > .05) in end-systolic volumes after closure. CONCLUSION: Increased peak LV twisting and torsion were attributed to the improved peak systolic clockwise basal rotation after TCC of large ASDs in children.
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El-Sisi et al. (2020) conducted an observational in Large secundum atrial septal defects (n=20). Transcatheter closure vs. Pre-closure baseline was evaluated on LV peak basal clockwise rotation (p=.005). Transcatheter closure of large ASDs in children significantly improved LV peak basal clockwise rotation from -6.9° to -10.3° (P=0.005) and LV twist from 11.3° to 17.5° (P=0.001) at 24 hours.
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