Trans-thoracic echocardiographic findings after the closure of ostium secundum atrial septal defect: A six-month follow-up study.

Abstract

Introduction: Adults with an atrial septal defect (ASD) have the third most frequent congenital heart disease. We aimed to determine the echocardiography findings after the defect closure in patients with ostium secundum ASD.

Methods: We included patients who underwent the closure of ostium secundum ASD using trans-catheter or surgical procedures. All patients were subjected to transthoracic echocardiography at admission, one month, and six months following successful closure. The remaining shunt were measured using contrast echocardiography and none of our patients had the remaining shunt.

Results: We evaluated 28 patients with a mean age of 35.67±11.55 years. Twelve (42.85%) individuals had trans-catheter, and 16 (57.14%) patients had surgical closure of ASD. After ASD closure, the left ventricular (LV) ejection fraction (P=0.02), and LV end-diastolic diameter significantly increased while S'_TAPSE, right atrial (RA) area, RA volume, and pulmonary artery pressure (PAP) markedly diminished (P<0.001). During follow-up, RV size changes showed a significant decrease during one (17.93%) and six (25.78%) months (P<0.001 for both cases) and become normal following six months after the ASD closure. In addition, the RA/LA area ratio dropped by 24.31% during the first month and 33.17% after six months (P<0.001). In addition, the changes in measured echocardiographic parameters were not significantly different over time between the trans-catheter and surgical procedures. The decrease in S'_TAPSE was significantly greater in the surgical group than in trans-catheter closure.

Conclusion: Closure of ostium secundum ASD dramatically decreased right cardiac chamber size and PAP while enhancing LV diameter and LV ejection fraction.