Haemodynamic effects of patent foramen ovale and atrial septal defect closure: a comparison during percutaneous shunt closure.
OBJECTIVE
We investigated the haemodynamic effect of percutaneous closure of an intra-atrial shunt, using non-invasive finger pressure measurements.


BACKGROUND
Percutaneous closure of both patent foramen ovale (PFO) and atrial septal defect (ASD) is widely practised. Currently no data are available on short-term haemodynamic changes induced by closure.


METHODS
Twenty-five consecutive patients (mean age 49 +/- 17 years, 10 men) who underwent a percutaneous closure of a PFO (n = 15) or ASD (n = 10) were included in this study. During the procedure blood pressure and heart rate (HR) were monitored continuously with a Finometer. Changes in systolic, mean, and diastolic pressure, stroke volume (SV), cardiac output (CO) and total peripheral resistance (TPR) were computed from the pressure registrations using Modelflow methodology.


RESULTS
Baseline characteristics were similar for the PFO and ASD patients. After PFO closure none of the haemodynamic parameters changed significantly. After ASD closure the systolic, mean, and diastolic pressures increased 7.1 +/- 5.4 (P = 0.003), 3.8 +/- 3.5 (P = 0.007) and 2.0 +/- 3.0 mmHg (P = ns) respectively. HR decreased 5.1 +/- 5.3 beats per minute (P = 0.01). SV, CO and TPR increased 8.5 +/- 6.4 ml (13.5%; P = 0.002), 0.21 +/- 0.45 l min(-1) (5.6%; P = ns) and 0.02 +/- 0.14 dynes (4.1%; P = ns) respectively. The changes in SV differ between the PFO and ASD patients (P = 0.009).


CONCLUSIONS
Using non-invasive finger pressure measurements, we found that SV, mean and systolic blood pressure increased immediately after percutaneous closure of an ASD in adults, whereas the percutaneous PFO closure had no effect on haemodynamic characteristics.
Department of Cardiology, St Antonius Hospital, Nieuwegein, the Netherlands.
Justin G L M
JG
Luermans
Willem J W
WJ
Bos
Martijn C
MC
Post
Jurriën M
JM
ten Berg
H W
HW
Thijs Plokker
Maarten J
MJ
Suttorp
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D006328:Cardiac Catheterization; D005260:Female; D054092:Foramen Ovale, Patent / Q000503:physiopathology* / Q000628:therapy*; D006339:Heart Rate / Q000502:physiology; D006344:Heart Septal Defects, Atrial / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation; D013318:Stroke Volume / Q000502:physiology