Related Experiment Video
Updated: Apr 12, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Incomplete RV Remodeling After Transcatheter ASD Closure in Pediatric Age
Hala M Agha1, Sonia A El-Saiedi2, Mohamed F Shaltout3
1Pediatric Cardiology Division, Pediatric Department, Faculty of Medicine, Specialized Pediatric Hospital, Cairo University, Kasr Al Aini street, Cairo, 11562, Egypt. halaazza@gmail.com.
Insights
Transcatheter device closure of atrial septal defect (ASD) improves ventricular function over 1 year. While initial improvements are seen, full normalization of right and left ventricular function by tissue Doppler imaging (TDI) is not achieved within the follow-up period.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Cardiac Physiology
Background:
- Data on the intermediate effects of transcatheter device closure for atrial septal defect (ASD) in children are limited.
- Atrial septal defects can impact right and left ventricular function.
Purpose of the Study:
- To evaluate the impact of transcatheter ASD closure on right and left ventricular functions using tissue Doppler imaging (TDI).
- To assess ventricular remodeling and performance metrics post-procedure.
Main Methods:
- Prospective study of 37 pediatric patients with ASD secundum undergoing transcatheter closure.
- Tissue Doppler imaging (TDI) and myocardial performance index (MPI) assessed at baseline and 1, 3, 6, and 12 months post-closure.
- Comparison with 37 age- and sex-matched healthy controls.
Main Results:
- Patients with ASD showed prolonged isovolumetric contraction, relaxation time, and MPI compared to controls.
- Post-closure, decreased tissue Doppler velocities and improved, but still prolonged, RV and LV MPI were observed at 1 month.
- Reverse remodeling of both ventricles began at 1 month but did not fully normalize within 1 year.
Conclusions:
- Transcatheter ASD closure initiates ventricular functional improvement and reverse remodeling within one month.
- Complete normalization of ventricular function and dimensions is not achieved by 1 year post-closure, indicating a need for longer-term follow-up.
Abstract:
Published data showing the intermediate effect of transcatheter device closure of atrial septal defect (ASD) in the pediatric age-group are scarce. The objective of the study was to assess the effects of transcatheter ASD closure on right and left ventricular functions by tissue Doppler imaging (TDI). The study included 37 consecutive patients diagnosed as ASD secundum by transthoracic echocardiography and TEE and referred for transcatheter closure at Cairo University Specialized Pediatric Hospital, Egypt, from October 2010 to July 2013. Thirty-seven age- and sex-matched controls were selected. TDI was obtained using the pulsed Doppler mode, interrogating the right cardiac border (the tricuspid annulus) and lateral mitral annulus, and myocardial performance index (MPI) was calculated at 1-, 3-, 6- and 12-month post-device closure. Transcatheter closure of ASD and echocardiographic examinations were successfully performed in all patients. There were no significant differences between two groups as regards the age, gender, weight or BSA. TDI showed that patients with ASD had significantly prolonged isovolumetric contraction, relaxation time and MPI compared with control group. Decreased tissue Doppler velocities of RV and LV began at one-month post-closure compared with the controls. Improvement in RVMPI and LVMPI began at 1-month post-closure, but they are still prolonged till 1 year. Reverse remodeling of right and left ventricles began 1 month after transcatheter ASD closure, but did not completely normalize even after 1 year of follow-up by tissue Doppler imaging.
