Key result
Transcatheter ASD closure linked to reduced RV dimensions at 6 months, predicted by younger age.
Why the study?
Variability in right heart reverse remodeling after transcatheter ASD closure remains understudied.
Does transcatheter ASD closure improve right ventricular parameters and tricuspid regurgitation severity in adult patients?
Observational (n=60)
Does transcatheter ASD closure improve right ventricular parameters and tricuspid regurgitation severity in adult patients?
p-value: p=<0.001
Transcatheter ASD closure leads to significant right heart reverse remodeling and TR improvement, with younger age and sinus rhythm predicting better echocardiographic outcomes.
Transcatheter ASD closure was associated with RV reverse remodeling and TR improvement; leaves open whether identified predictors should guide patient selection.
Transcatheter atrial septal defect (ASD) closure is a minimally invasive procedure, yet variability in right heart reverse remodeling post-procedure remains understudied. To evaluate the impact of transcatheter ASD closure on right ventricular (RV) parameters and tricuspid regurgitation (TR) severity over six months, and to identify predictors of RV reverse remodeling and TR improvement. This prospective study included 60 adult patients who underwent successful transcatheter ASD closure. Transthoracic echocardiography was performed at baseline, and at 1, 3, and 6 months post-procedure to assess RV dimensions, systolic function, and TR severity. Significant reductions were observed in RV dimensions—including tricuspid annular diameter, RV basal diameter, RV mid-cavity diameter, and RV outflow tract diameter—at 6 months ( p < 0.001). RV systolic function declined at 1 month and remained stable thereafter. TR severity improved significantly at 1 and 3 months. Predictors of RV reverse remodeling at 6 months included younger age (OR: 0.949; 95 % CI: 0.913–0.986), sinus rhythm (OR: 0.113; 95 % CI: 0.022–0.569), lower shunt ratio (OR: 0.259; 95 % CI: 0.068–0.993). Predictors of TR improvement included the same factors, in addition to smaller tricuspid annular diameter and smaller right atrial end-systolic area. Transcatheter ASD closure leads to significant right heart reverse remodeling and TR improvement. Younger age, sinus rhythm, and smaller preprocedural chamber dimensions predict RV reverse remodeling and improvement of TR, supporting their role in patient selection and clinical decision-making. • Transcatheter ASD closure leads to a progressive reduction in RV dimensions and tricuspid annular diameter indicating reverse remodeling of the right heart. • Tricuspid regurgitation significantly decreases in severity following transcatheter ASD closure, with the most notable improvements occurring within the first three months after closure, suggesting a positive impact on valve function. • Age, atrial fibrillation, shunt ratio, preprocedural right atrial end-systolic area, and tricuspid annular diameter were identified as key factors influencing the extent of right heart reverse remodeling and tricuspid regurgitation improvement.
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Etman et al. (2025) conducted an observational in Atrial septal defect (ASD) (n=60). Transcatheter ASD closure vs. Baseline was evaluated on Reductions in right ventricular dimensions at 6 months (p=<0.001). Transcatheter ASD closure significantly reduced right ventricular dimensions at 6 months (p<0.001), with younger age (OR 0.949) predicting right heart reverse remodeling.
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