Impact of the Amplatzer atrial septal occluder device on left ventricular function in pediatric patients

Area of Science:

• Cardiology
• Pediatric Cardiology
• Medical Devices

Background:

• Percutaneous closure is the preferred treatment for ostium secundum atrial septal defects (ASD).
• The Amplatzer Septal Occluder (ASO) is a commonly used device, but its effect on cardiac function requires further investigation.
• Understanding device size impact is crucial for optimizing patient outcomes.

Purpose of the Study:

• To assess the influence of Amplatzer Septal Occluder device size on left ventricular (LV) function in pediatric patients.
• To utilize speckle-tracking strain imaging to evaluate subtle changes in LV function.
• To compare LV function across different ASO device size groups and a control group.

Main Methods:

• Enrolled 43 pediatric patients undergoing percutaneous ASD closure with ASO devices.
• Grouped patients into small (≤10 mm), medium (11-16 mm), and large (≥17 mm) device size categories.
• Compared echocardiographic data, including strain rate analysis, with a control group of 50 patients.

Main Results:

• The large-device group exhibited significantly impaired basal LV strain rate values compared to controls and smaller device groups.
• Mean basal circumferential and radial strain rates were notably lower in the large-device group.
• Multivariate analysis identified absolute device diameter as a significant factor impacting LV function.

Conclusions:

• Larger Amplatzer Septal Occluding devices significantly impair left ventricular systolic function, especially in juxtaprosthetic segments.
• Strain rate analysis effectively demonstrated the detrimental effects of larger devices on LV function.
• Careful consideration of ASO device size is essential for preserving cardiac function in pediatric ASD patients.