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Long-Term Left Atrial Function after Device Closure and Surgical Closure in Adult Patients with Atrial Septal Defect
Jeong Sook Seo1, Young Ah Park2, Jin Hong Wi3
1Division of Cardiology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea. orifilter@hanmail.net.
Journal of Cardiovascular Imaging
|February 19, 2021
Summary
Percutaneous closure of atrial septal defects (ASDs) may impair left atrial (LA) function, while surgical closure does not. Two-dimensional speckle tracking echocardiography effectively assesses LA function post-ASD treatment.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Atrial septal defect (ASD) closure is common, but its impact on left atrial (LA) function requires further investigation.
- Limited studies compare LA function after surgical versus percutaneous ASD closure.
Purpose of the Study:
- To compare left atrial (LA) function between surgical closure (ASD-S) and percutaneous device closure (ASD-D) in adult ASD patients.
- To evaluate the efficacy of 2D speckle tracking echocardiography (STE) in assessing LA function post-ASD treatment.
Main Methods:
- Retrospective analysis of adult patients (age >20) with ASD treated surgically (ASD-S) or percutaneously (ASD-D).
- Transthoracic echocardiography and 2D STE were used to measure LA peak systolic, early diastolic, and late diastolic strain (reservoir, conduit, contraction).
- Comparison of LA strain values between ASD-S, ASD-D, and control groups 1-3 years post-treatment.
Main Results:
- Patients with percutaneous closure (ASD-D) showed significantly reduced LA reservoir strain compared to controls (25.2% ± 7.4% vs. 33.6% ± 5.5%, p=0.004).
- LA conduit and contraction strains were also significantly lower in the ASD-D group versus controls (-13.8% ± 5.8% vs. -20.4% ± 4.7%, p=0.034; -11.3% ± 4.2% vs. -13.2% ± 2.5%, p=0.037).
- No significant differences in LA reservoir, conduit, or contraction strains were observed between the surgical closure (ASD-S) and control groups, or between ASD-S and ASD-D groups.
Conclusions:
- Two-dimensional speckle tracking echocardiography is a reliable method for assessing left atrial function after ASD closure.
- Percutaneous device closure of ASDs in adults is associated with reduced left atrial reservoir, conduit, and contraction function one year post-procedure compared to controls.
- Surgical closure of ASDs does not appear to negatively impact left atrial function compared to controls or percutaneous closure.
