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Related Experiment Videos

Right ventricular form and function after percutaneous atrial septal defect device closure.

G R Veldtman1, V Razack, S Siu

  • 1Congenital Cardiac Centre for Adults, University of Toronto and Toronto General Hospital, Ontario, Canada.

Journal of the American College of Cardiology
|June 23, 2001
PubMed
Summary

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Percutaneous closure of atrial septal defects (ASDs) significantly improves right heart size and function within one month. While most patients benefit, a small percentage experience persistent right ventricular enlargement or pulmonary hypertension one year post-procedure.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Adult Congenital Heart Disease

Background:

  • Percutaneous closure effectively reduces or eliminates interatrial shunting in atrial septal defects (ASDs).
  • The long-term impact of device closure on the adult right heart remains incompletely understood.

Purpose of the Study:

  • To evaluate the right heart's response to percutaneous device closure of moderate-sized ASDs in adults.
  • To assess changes in right heart morphology and function over a one-year follow-up period.

Main Methods:

  • Forty adult patients with moderate ASDs underwent percutaneous device closure (CardioSeal or Amplatzer).
  • Echocardiography, chest radiography, and electrocardiography were performed pre-procedure and at 1, 6, and 12 months post-procedure.

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Main Results:

  • Significant reductions in heart size, right ventricular (RV) size, QRS duration, PR interval, and pulmonary artery systolic pressure were observed by one month and maintained at 12 months.
  • Right atrial length decreased by six months post-closure.
  • Twenty-nine percent of patients exhibited persistent RV enlargement at one year.

Conclusions:

  • Transcatheter closure of ASDs leads to rapid and significant improvement in right heart morphology and function within one month.
  • While generally safe and effective, a minority of patients may experience persistent RV enlargement or pulmonary hypertension.
  • Transcatheter methods offer excellent hemodynamic and anatomic outcomes for ASD closure.