Changes of cardiac function after transcatheter closure of atrial septal defect and during the follow-up

Objective To evaluate the changes of right, left ventricular function and left atrial contraction function after transcatheter closure of atrial septal defect (ASD) and during a short term follow up. Methods Twenty patients with secundum ASD underwent echocardiographic examination before and after transcatheter closure and during the short term follow up. There were 12 males and 8 females, aged from 8 to 52 years. The balloon stretched diameter of ASD was (22.79±6.22)mm. Amplatzer septal occluders were placed in 16 patients and Cardio SEAL occluders in 4 patients. Right and left ventricular volumes were calculated with the single plane area length method. Atrial filling fraction (AFF) was used as the parameter of the left atrial contraction function. Results After transcatheter closure, left ventricular end diastolic diameter and left ventricular end diastolic volume significantly increased while left ventricular end systolic volume was stable. Thus, left ventricular stroke volume, left ventricular ejection fraction and shortening fraction significantly increased, suggesting the presence of an improvement of left ventricular preload and left ventricular function; the eccentricity decreased significantly, suggesting the presence of an improvement of left ventricular geometry. During follow up, the improvements of left ventricular function and geometry were maintained. After transcatheter closure, right ventricular end diastolic diameter (RVEDD), right ventricular end diastolic volume (RVEDV), right ventricular end systolic volume (RVESV), right ventricular stroke volume (RVSV) and right ventricular ejection fraction (RVEF) decreased significantly. During the follow up, RVEDD, RVEDV, RVESV and RVSV decreased further, but RVEF was stable. The AFF was not changed significantly after the transcatheter closure and during the follow up. Conclusions Transcatheter closure of ASD not only decreases the preload of right ventricle, but also significantly improves left ventricular systolic function and geometry. At least during short term follow up, the improvement of left ventricle could be maintained while the right function is stable on normal level. Placement of occluder does not change the left atrial contraction function significantly.