Evaluation of the changes of right ventricular volume and function by using single beat real-time 3-D echocardiography in patients with atrial septal defect before and after percutaneous closure

Objective To evaluate the changes of right ventricular(RV) volume and function by using single beat real- time three dimensional(3- D) echocardiography in patients with atrial septal defect(ASD) before and after percutaneous closure. Methods During the period from July 2011 to Oct. 2013, a total of 45 patients with pure ostium secundum defect were admitted to authors' hospital to receive percutaneous transcatheter closer. The patients were divided into ASD without pulmonary hypertension(PH) group(group A, n = 28) and ASD with PH group(group B, n = 17). By using 3- D echocardiography and right cardiac catheterization, the right ventricular end- diastolic volume(RVEDV), right ventricular end-systolic volume(RVESV), right ventricular stroke volume(RVSV), right ventricular ejection fraction(RVEF), right ventricular cardiac output(RVCO), pulmonary artery systolic pressure(PASP) and the mean pulmonary artery pressure(mPAP) were determined before and after the percutaneous transcatheter closer. The results were compared between the two groups. Results After the treatment a statistically significant reduction in RVEDV, RVESV, RVSV and RVCO were seen in all patients(P 0.05). In group A, RVEF decreased significantly after ASD closure when compared with that determined before transcatheter closer(P 0.05), while no significant reduction in RVEF was seen in group B(P 0.05). Pulmonary artery pressure(PAP) decreased significantly in group B after ASD closure when compared with that obtained before transcatheter closer(P 0.05). Conclusion Single beat real- time 3- D echocardiography is a newly- developed technique. This technique can quickly and accurately assess the right ventricular volume and function. Right ventricular volume willdecrease after ASD closer. In ASD patients without PH the right ventricular function will decrease after ASD closer, while in ASD patients with PH the right ventricular function shows no changes after ASD closer although their PAP will decrease.