Doppler tissue imaging analysis of ventricular function after surgical and transcatheter closure of atrial septal
Yiu-fai Cheung1, Kin-shing Lun, Adolphus K T Chau
1Division of Pediatric Cardiology, Department of Pediatrics and Adolescent Medicine, Grantham Hospital, The University of Hong Kong, Hong Kong, China. xfcheung@hkucc.hku.hk
Insights
Surgical closure of atrial septal defects may impair long-term right ventricular function in children. However, transcatheter device closure preserves this function, offering a potentially better long-term outcome for pediatric patients.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Interventional Cardiology
Background:
- Secundum atrial septal defects (ASD) are common congenital heart conditions in children.
- Surgical and transcatheter closure are primary treatment options for ASD.
- Long-term functional outcomes, particularly ventricular function, require further investigation.
Purpose of the Study:
- To assess and compare the long-term ventricular function in children following surgical versus transcatheter closure of secundum ASD.
- To evaluate the impact of different closure methods on right ventricular performance.
Main Methods:
- Doppler tissue imaging (DTI) was utilized to assess ventricular function.
- Patients undergoing surgical or transcatheter ASD closure were compared with age-matched healthy controls.
- Key echocardiographic parameters including systolic and diastolic tricuspid annular velocities and Tei index were analyzed.
Main Results:
- Children who underwent surgical closure exhibited impaired long-term right ventricular function.
- This impairment was evidenced by decreased systolic and diastolic tricuspid annular velocities and an elevated Tei index.
- In contrast, right ventricular function remained preserved in children treated with transcatheter device closure.
Conclusions:
- Transcatheter device closure appears to be associated with better long-term right ventricular functional outcomes compared to surgical repair in pediatric patients with secundum ASD.
- DTI is a valuable tool for assessing subtle long-term functional changes in pediatric cardiac patients.
- These findings may influence the choice of closure strategy for secundum ASD in children.
Abstract:
The long-term ventricular function of children after surgical and transcatheter closure of secundum atrial septal defects was assessed by Doppler tissue imaging and compared with that of age-matched controls. Long-term right ventricular function was impaired in patients after surgical repair, as reflected by decreased systolic and diastolic tricuspid annular velocities and an increased Tei index. In contrast, right ventricular function was preserved after transcatheter device closure.
