Key result
Transcatheter ASD closure is linked to a ~20% reduction in RV size and increased LV dimensions.
Why the study?
The acute cardiac remodeling process after transcatheter closure of atrial septal defect in adult patients was not well characterized.
Does transcatheter closure of ASD improve echocardiographic parameters of cardiac remodeling in adult patients with secundum ASD?
Observational (n=19)
Does transcatheter closure of ASD improve echocardiographic parameters of cardiac remodeling in adult patients with secundum ASD?
Transcatheter closure of ASD in adults leads to an immediate decrease in RV size and an increase in LV size, accompanied by early improvement in LV function but transient deterioration in RV function.
Answers are grounded in this paper and cite their sources.
May support short-term monitoring after ASD closure; leaves open long-term effects in larger cohorts.
OBJECTIVE: The aim of this study was to evaluate acute cardiac remodeling after transcatheter closure of atrial septal defect (ASD) in adult patients. METHODS: This study included 19 patients (40.0 ± 13.51 mean age) with secundum ASD who underwent successful transcatheter closure. All patients received routine transthoracic echocardiography, including tissue Doppler left ventricle (LV) and right ventricle (RV) myocardial performance indices (MPI), mitral annular plane systolic excursion (MAPSE) and tricuspid annular plane systolic excursion (TAPSE) before ASD closure, on first day, and at first and third months after closure. RESULTS: Left ventricle end-diastolic diameter (LVEDD) increased (37 ± 4 mm to 44 ± 5 mm, p<0.001); RVEDD decreased markedly after closure (40 ± 4 mm to 32 ± 5 mm, p<0.001); and differences existed in LV and RV adaptation. While MAPSE (1.87 ± 0.22 cm to 2.01 ± 0.23 cm, p<0.001) and LVMPI improved soon after procedure (0.44 ± 0.04 to 0.36 ± 0.03, p<0.001), RVMPI worsened until the first month post-procedure (0.25 ± 0.02 to 0.31 ± 0.03, p<0.001), but recovered by the third month follow-up visit (0.31 ± 0.03 to 0.27 ± 0.02, p<0.001). TAPSE remained unchanged (2.49 ± 0.46 cm to 2.51 ± 0.32 cm, p=0.078). CONCLUSION: Closure of ASD using the Amplatzer Septal Occluder device led to a decrease in RV size and an increase in LV size. In the early period, while LV function improved, RV function deteriorated, probably due to RV functional and anatomical differences.
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A 2015 study conducted an observational in Secundum atrial septal defect (n=19). Transcatheter closure of atrial septal defect vs. Pre-procedure baseline was evaluated on Acute cardiac remodeling (LVEDD, RVEDD, MAPSE, LVMPI, RVMPI, TAPSE) (p=<0.001). Transcatheter closure of atrial septal defect decreased right ventricular size and increased left ventricular size.
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