title: Impact of the Amplatzer atrial septal occluder device on left ventricular function in pediatric patients.
abstract: Percutaneous closure currently is widely considered to be the first-choice therapeutic option in the treatment of ostium secundum atrial septal defect (ASD). The Amplatzer Septal Occluder (ASO) device is the most used prosthesis, although its influence on cardiac function still is under active investigation. This study aimed to evaluate the impact of the ASO device size on left ventricular (LV) function in pediatric patients using the speckle-tracking strain imaging technology. The study enrolled 43 nonobese pediatric patients submitted to percutaneous ASD closure with the Amplatzer Septal Occluder device and grouped them according to the size of the occluding prosthesis into three groups: a small-device group (≤ 10 mm, group 1), a medium-size-device group (11-16 mm, group 2), and a large-device group (≥ 17 mm, group 3). Echocardiographic data were compared among the groups and with the data of an age-, weight-, and gender-matched control group (50 patients). The large-device group showed a significant impairment in the strain rate value of the basal LV segments. In particular, the mean basal circumferential and radial strain rate values were lower than either normal or the values of the small- and medium-device groups. However, only the absolute device diameter reached statistical significance in the multivariate analysis. The large Amplatzer Septal Occluding device significantly impaired LV systolic function, particularly that of juxtaprosthetic segments, as shown in the strain rate analysis.
authors.affiliation: Pediatric Cardiology, "Ospedali dei Colli" Hospital, 2nd University of Naples, Via C. Colombo, 19, 80033, Cicciano, NA, Italy, b.castaldi@yahoo.it.
authors.forename: Biagio
authors.initials: B
authors.lastname: Castaldi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Santoro
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Salvo
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Gaio
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Palladino
authors.forename: Fabio
authors.initials: F
authors.lastname: D'Aiello
authors.forename: Carola
authors.initials: C
authors.lastname: Iacono
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pacileo
authors.forename: Raffaele
authors.initials: R
authors.lastname: Calabrò
authors.forename: Maria Giovanna
authors.initials: MG
authors.lastname: Russo
mesh_terms: D006328:Cardiac Catheterization; D002648:Child; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D055989:Septal Occluder Device; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left