Morphologic, mechanical, conductive, and hemodynamic changes following transcatheter closure of atrial septal defect.
OBJECTIVE
The secundum type of atrial septal defect (ASD) is a common congenital cardiac anomaly. Transcatheter closure of the defect is the preferable therapeutic approach to avoid potential future complications. This work extends the data collected so far regarding the electrocardiographic, morphologic, hemodynamic, and mechanical changes following the procedure.


METHODS
From April 2002 to October 2003, 42 consecutive patients underwent successful transcatheter closure of secundum type ASD. They were sampled for different parameters by transthoracic echocardiography before the procedure and at three different points over the next 4 years, and analyzed in two age groups: children and adults.


RESULTS
The dimensions of the chambers normalized throughout the study period. Abnormal movement of the interventricular septum normalized mostly during the first month, but its thickness increased gradually to normal levels during the 4 years of the study. High elevated pulmonary artery pressure values began declining to near normal levels from the second month following the procedure. The stroke volume and the right bundle branch block pattern improved throughout the study period.


CONCLUSIONS
Transcatheter ASD closure is followed by morphologic, conductive, and hemodynamic changes at different time intervals during the first years and results in normalization or near normalization of the heart's structure and function.
Mainzer
Gur
G
Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Braver
Yulia
Y
Khoury
Assad
A
Schwartz
Yitzhak
Y
Galenter-Yaniv
Liat
L
Yalonetsky
Sergey
S
Lorber
Avraham
A
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002037:Bundle-Branch Block / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006328:Cardiac Catheterization / Q000295:instrumentation; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000503:physiopathology; D055989:Septal Occluder Device; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right; D054088:Ventricular Septum / Q000000981:diagnostic imaging / Q000503:physiopathology; D055815:Young Adult