Assessment of Left Ventricular Systolic Function after Surgical and Transcatheter Device Closure of Ventricular Septal Defect Using Speckle Tracking Imaging

Abstract

Objectives: To evaluate left ventricular (LV) systolic function in pediatric patients after ventricular septal defect (VSD) closure using conventional echocardiography and 2D speckle tracking derived strain. Background: VSD is a common congenital heart disease. Transcatheter device closure is an effective alternative to surgical closure with fewer complications. Methods: This prospective study included 54 children, divided into three groups: surgical closure (n=18), transcatheter closure (n=18), and control group (n=18). LV function was assessed before and one week and six weeks after closure using conventional echocardiogram and 2D speckle tracking derived strain including longitudinal, circumferential, and radial strain. Results: The study included 54 children aged from 6 months to 3 years. Perimembranous VSD was the most common type in the surgical group, while muscular VSD was the most common in the transcatheter group. Global longitudinal strain (GLS) was better in both VSD groups compared to control group before closure. LV ejection fraction (EF) and 2D global strain values decreased in both VSD groups after closure in the first assessment, but then recovered in the second assessment. Conclusion: There is a significant decrease in LV function immediately after closure detected by LVEF and 2D LV strain. The decline is more significant in patients who underwent surgical closure compared to transcatheter closure. Furthermore, the study highlights the usefulness of LV 2D strain in assessing LV systolic function in pediatric patients.