Transient abnormal septal motion after non-surgical closure of the ductus arteriosus

Abnormal septal motion on M mode echocardiography was seen in eight of 16 patients soon after non-surgical closure of the ductus arteriosus. Ten to twenty-nine months after the procedure the abnormal septal motion had disappeared spontaneously. The cross section of the left ventricular cavity was circular both when septal motion was abnormal and when it was normal. Cross sectional echocardiography showed that there was an exaggerated anterior swinging motion of the heart in systole in patients with abnormal septal motion on the M mode recordings. The left ventricular end diastolic diameter before closure was significantly larger, and its reduction after closure was more pronounced in those with abnormal septal motion than in those without. This suggested that the abnormal septal motion was associated with relief of long standing left ventricular volume overload. It is suggested that acute shrinkage of the heart caused temporary laxity of the pericardium, and consequently more movement of the heart within the thorax. The return of normal septal motion suggests that the pericardium gradually shrank to accommodate the smaller heart.