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The Effect of Atrial Septal Defect Closure on cardiac Volumetric Changes in Adults, Transcatheter Versus Surgical Closure, a Pilot cardiac Magnetic Resonance Study

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Congenital Heart Disease 2023年第6期18卷 679-691页

作者： Amr Mansour Noha M.Gamal Alaa M.Nady Amr Ibraheem Dalia M.Salah Khaled M.El-Maghraby Cardiology Department Congenital and Structural Heart Disease UnitAin Shams University HospitalsFaculty of MedicineAin Shams UniversityCairoEgypt Cardiology Department Faculty of MedicineAssuit UniversityAssuitEgypt Cardiothoracic Surgery Department Faculty of MedicineAssuit UniversityAssuitEgypt Anesthesia Department Faculty of MedicineAssuit UniversityAssuitEgypt

Background:Closure of an atrial septal defect(ASD)reduces right-side heart volumes by abolishing shunting with simultaneous improvement of the left ventricle(LV)ﬁlling and functions due to ventricular interdependence,thereby improving ***,studies conducted on atrial volume changes after ASD closure are *** magnetic resonance(cmr)is considered as the gold standard method for measuring cardiac volume and ***:We aimed to study the effect of transcatheter and surgical closure of secundum ASD on cardiac volumes and systolic functions as well as the fate of tricuspid regurgitation(TR),using cmr ***:We prospectively enrolled 30 adult patients with isolated secundum ASD who were referred to ASD *** evaluation of cardiac chambers indexed volumes,systolic function,myocardial mass index,and tricuspid regurgitant fraction were done at before and 6 months after ***:RV volumes decreased in both groups when compared to baseline(p-value 0.001),the device group had more reduction in volumes and more improvement in RV function after closure(p-value 0.001)when compared to the surgical *** changes in the RV mass index were insigniﬁcant between both groups(p-value 0.31).Functional TR improved to the same extent in both *** ventricular end diastolic volume index(LVEDVI)and LV mass index increased sig-niﬁcantly in both groups when compared to baseline in both groups but with no difference between groups p-value 0.01),left ventricular end systolic volume index(LVESVI)changes were insigniﬁ*** systolic function improved in patients who underwent device closure only(63.53±3.85 vs.67.13±4.34,p-value 0.01).There was a signiﬁcant reduction in right atrial(RA)volumes and an insigniﬁcant decrease in left atrial(LA)volumes,with no difference between ***:Transcatheter and surgical secundum ASD closure resulted in volumetric changes in some cardiac chambers with better improvement in bi-ventricular

关键词： Atrial septal defect closure cardiac volumetric changes functional tricuspid regurgitation cardiac cmr

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