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Published on: February 8, 2022
The Effect of Transcatheter Atrial Septal Defect Closure on Left Heart Function in Pediatric Patients
Ayşe Sülü1, Derya Aydın Şahin2, Osman Başpınar3
1Department of Pediatric Cardiology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey.
Insights
Transcatheter closure of atrial septal defects (ASDs) improved cardiac function in children. Tissue Doppler imaging confirmed enhanced left ventricular diastolic and left atrial systolic function post-procedure without adverse device effects.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Cardiac Physiology
Background:
- Secundum atrial septal defects (ASDs) can impact cardiac function.
- Transcatheter closure is a common treatment for ASDs.
- Evaluating cardiac function post-procedure is crucial.
Purpose of the Study:
- To assess left atrial systolic and left ventricular (LV) diastolic function using tissue Doppler imaging (TDI) after transcatheter ASD closure.
- To evaluate changes in left atrial ejection force in pediatric patients following ASD repair.
Main Methods:
- TDI measurements of left atrial ejection force, mitral valve, and left atrial volume were performed.
- Evaluations were conducted pre-procedure and at multiple time points post-procedure (1st day, 10th day, 1st month, 3rd month).
- A cohort of 56 pediatric patients and 28 healthy controls were included.
Main Results:
- A transient decrease in septal and lateral a' velocities was observed on the first day post-procedure.
- Septal e'/a' parameters significantly improved by the third month.
- Left atrial ejection force was initially lower in ASD patients but significantly increased post-procedure, nearing control group levels.
Conclusions:
- Transcatheter ASD closure leads to improvements in LV diastolic and left atrial systolic function in children.
- The devices used for transcatheter ASD closure demonstrated no negative impact on cardiac function.
Objective:
The aim of this study was to use tissue Doppler imaging to evaluate the left atrial systolic and the left ventricular (LV) diastolic function as well as the left atrial ejection force in children who underwent transcatheter closure of a secundum atrial septal defect (ASD).
Methods:
Tissue Doppler measurements of the left atrial ejection force, the mitral valve, and left atrial volume were performed before the ASD closure procedure, and on the 1st day, 10th day, and 1st and 3rd months after the procedure in 56 patients and in 28 healthy controls.
Results:
There was a significant decrease in the septal and lateral a' velocities on the first day (p<0.05). There was a statistically significant increase in the septal e'/a' parameters at the third month compared with the initial measurements. The left atrial ejection force was lower in patients with an ASD than in the healthy group (10.69±4.94 kdyn, 12.31±4.05 kdyn, respectively), but there was no significant difference (p=0.053). The left atrial ejection force was significantly greater in the patient group 3 months after the procedure, and there was no significant difference compared with the control group.
Conclusion:
Improvement in the LV diastolic and left atrial systolic functions was observed in children who underwent transcatheter closure of an ASD. There was no negative effect related to the devices used.
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