Short-Term Cardiac Functional Change Following Transcatheter Atrial Septal Defect Closure: A Prospective...

Area of Science:

• Cardiology
• Cardiovascular Surgery
• Medical Devices

Background:

• Atrial septal defect (ASD) is a prevalent congenital heart anomaly leading to significant hemodynamic compromise if left untreated.
• Transcatheter closure is a standard, minimally invasive treatment for ASD, yet data on short-term cardiac remodeling remain limited.

Purpose of the Study:

• To assess short-term echocardiographic alterations in cardiac structure and function post-transcatheter ASD closure in adult patients.
• Evaluate the impact of transcatheter ASD closure on key echocardiographic parameters.

Main Methods:

• A prospective observational cohort study involving 112 adult patients (15-68 years) undergoing transcatheter ASD closure.
• Comprehensive echocardiography was performed before and at 1 and 6 months post-procedure.
• Key parameters included ventricular dimensions, atrial volumes, right ventricular systolic pressure (RVSP), pulmonary artery pressure (PAP), tricuspid regurgitation (TR), and right ventricular ejection fraction (RVEF).

Main Results:

• Significant reductions observed at 6 months in right atrial volume index (RAVI), right ventricular internal diameter, RVSP, PAP, and TR severity (p < 0.05).
• Left ventricular dimensions and ejection fraction remained stable, confirming preserved left-heart function.
• Right ventricular ejection fraction (RVEF) improved in 31% of patients; cardiac rhythm was unaffected. Remodeling was independent of baseline ASD size.

Conclusions:

• Transcatheter ASD closure leads to early and sustained right-heart reverse remodeling and pulmonary pressure reduction.
• The procedure demonstrates safety and efficacy, with no adverse effects on left ventricular function or cardiac rhythm.
• Consistent benefits regardless of defect size underscore the value of this minimally invasive approach.