[The effects of different occluder selection on cardiac remodeling post transcatheter closure in patients with secundum atrial septal defect]
Related Experiment Video
Updated: Jun 16, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Tian-He Yang1, Yong-Yao Yang, Qing-An Jiang
1Department of Cardiology, Guizhou Provincial People's Hospital, Guiyang 550002, China.
Insights
Selecting atrial septal defect (ASD) occluders using the oval circumference formula leads to better cardiac remodeling compared to echocardiography. This method offers improved outcomes for patients undergoing transcatheter closure.
Area of Science:
- Cardiology
- Medical Devices
- Cardiac Surgery
Background:
- Atrial septal defect (ASD) closure is a common procedure.
- Optimizing device selection is crucial for favorable post-procedural cardiac remodeling.
- Transcatheter closure with Amplatzer septal occluders is a widely used technique.
Purpose of the Study:
- To compare cardiac remodeling after transcatheter ASD closure using Amplatzer septal occluders selected by the oval circumference formula versus echocardiography.
- To evaluate the long-term effects on cardiac dimensions and function.
Main Methods:
- 146 patients with ASD underwent transcatheter closure with Amplatzer occluders.
- Defect size was determined by the oval circumference formula (Group A) or echocardiography (Group B).
- Cardiac remodeling was assessed using transthoracic echocardiography at baseline and follow-up points (3 days, 3 months, 6 months).
Main Results:
- Both methods achieved high procedural success rates (97.3%) with no residual shunts or complications.
- The oval circumference formula resulted in smaller occluder sizes compared to echocardiography.
- Group A showed significantly greater reductions in right atrial and ventricular dimensions and improved atrial and ventricular size ratios at 6 months compared to Group B.
Conclusions:
- Occluder selection based on the oval circumference formula promotes more favorable cardiac remodeling post-ASD closure.
- This method offers a superior approach for optimizing patient outcomes after transcatheter ASD repair.
Objective:
To evaluate the effects on cardiac remodeling post transcatheter closure by Amplatzer septal occluder selected by oval circumference formula in patients with atrial septal defect (ASD).
Methods:
A total of 146 patients with ASD (68 males,mean 33.5 years) treated by transcatheter closure with the Amplatzer occluder were enrolled in this study. The diameter of defects was corrected with the oval circumference formula (group A, 73 cases) or by echocardiography (group B, 73 cases). Cardiac remodeling was assessed by transthoracic echocardiography (TTE) before the procedure, 3 days, 3 months and 6 months after ASD closure.
Results:
The mean ASD diameter was similar between the two groups [(20.16 +/- 4.98) mm vs. (21.36 +/- 5.69) mm, P > 0.05] and the mean diameter of the selected occluder of group A was significantly smaller than that in group B [(21.95 +/- 6.78) mm vs. (25.85 +/- 6.75) mm, P < 0.05]. Procedural success rate was identical between the two groups (97.3%) and the defects were completely occluded and there was no residual shunt during the 6 months follow up period, there were also no complications during and after the procedure. The lateral diameter of right atrial (RALD), the diastolic diameter of right ventricle (RVDD), RALD/LALD, RVDD/LVDD and pulmonary diameter (PD) were significantly decreased while the lateral diameter of left atrial (LALD) and left ventricle (LVDD) were significantly increased post ASD closure in both groups. At 6 months follow up, RALD decreased by (18.63 +/- 10.59)% in group A versus (10.14 +/- 6.59)% in group B, LALD increased by (13.42 +/- 8.38)% in group A versus (9.28 +/- 4.95)% in group B and RALD/LALD ratio decreased by (26.35 +/- 11.24)% in group A versus (13.98 +/- 8.96)% in groups B (all P < 0.05).
Conclusion:
ASD occluder selection based on the oval circumferen ce formula is superior to that made by echocardiography in terms of more favorable cardiac remodeling post ASD closure.
