Evaluation of Right Ventricular Function in Early Period Following Transcatheter Closure of Atrial Septal Defect

Abstract

Aims: There is limited data on alterations in novel right ventricular (RV) function indices like tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular systolic velocity (TASV) after transcatheter atrial septal defect (ASD) closure. We aimed to evaluate RV function by echocardiography (ECG) with these novel indices in early period in patients with secundum-type ASD that was closed percutaneously. Methods: Patients were enrolled to study if they had secundum-type ASD that was suitable for percutaneous closure. Patient population consisted of 4 men and 16 women. Echocardiography was performed before and 1 month after closure. Results: Mean age was 37 +/- 16. Mean diameter of ASD and total atrial septum length measured by ECG were 19 +/- 6 mm and 49 +/- 7 mm, respectively. Mean diameter of defect in transesophageal echocardiography was 20 +/- 6 mm. Stretched mean diameter in catheterization was 23 +/- 6 mm. One month after closure, there were statistically significant decreases in RV end-diastolic diameters (43.3 +/- 10.7 mm vs. 34.9 +/- 5.5 mm; P < 0.001), RV/left ventricular (LV) end-diastolic diameter ratio (1.1 +/- 0.3 vs. 0.87 +/- 0.1; P < 0.001), TASV (16.9 +/- 3.2 cm/sec vs. 14.3 +/- 3.3 cm/sec; P < 0.05), early diastolic tricuspid annular velocity (15.3 +/- 3.1 cm/sec vs. 13.4 +/- 2.4 cm/sec P <0.05), late diastolic tricuspid annular velocity (16.2 +/- 5.4 cm/sec vs. 14.3 +/- 6.3 cm/sec; P < 0.05), and TAPSE (29.9 +/- 6.2 mm vs. 22.4 +/- 7.4 mm; P < 0.001). LV end-diastolic diameter (38.0 +/- 6.9 mm and 40.0 +/- 4.5 P < 0.05) was increased, whereas there was no change in LV ejection fraction. Conclusion: Closure of ASD by using Amplatzer devices led to decrease in right heart chamber size, tissue Dopplerderived tricuspid annular velocities and TAPSE in early period. (Echocardiography ****;**:1-5)