Document Detail


Resolution of right heart enlargement after closure of secundum atrial septal defect with transcatheter technique.
MedLine Citation:
PMID:  11691535     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to prospectively characterize the reduction in right atrial (RA) area and right ventricular (RV) volume after transcatheter closure of atrial septal defect (ASD) and to investigate factors that may predict magnitude of resolution in right heart enlargement. BACKGROUND: Secundum ASD can cause volume overload of the right side of the heart with the potential for development of late complications. Little is known about reduction in right heart size after closure of ASD. METHODS: Transthoracic echocardiography was performed in 38 patients undergoing transcatheter closure of ASD. The RA area and RV volume were measured prior (n = 38), within 24 hours (n = 37), at 3 to 6 months (n = 24), at 12 months (n = 20) and at 24 months (n = 10) after closure of ASD. Change over time within the study group was assessed and the study group was compared to a control group of 19 patients with structurally normal hearts. RESULTS: Indexed RA area decreased from baseline to 3- to 6-month follow-up (p = 0.004) as did indexed RV volume (p < 0.0001). Indexed RV volume was similar to that in the control group at 24 months (p = 0.3); however, indexed RA area remained greater than in the control group (p = 0.006). Decrease in indexed RA area over the first 12 months of follow-up was related to young age at time of closure by regression analysis (r = 0.55, p = 0.013). CONCLUSION: Closure of secundum ASD results in decreased indexed RV volume comparable to that in control subjects at 24 months following closure. Indexed RA area remains increased compared to that in control subjects but does decrease over time. Decrease in RA area is inversely proportional to age at time of ASD closure. Long-term follow-up is required to evaluate the clinical impact of persistently increased RA size.
Authors:
H W Kort; D T Balzer; M C Johnson
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  38     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-11-05     Completed Date:  2001-12-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1528-32     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Department of Pediatrics, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, Missouri 63110, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Analysis of Variance
Balloon Occlusion / adverse effects,  instrumentation,  methods*
Cardiac Volume*
Cardiomegaly / etiology*,  physiopathology,  ultrasonography*
Case-Control Studies
Child
Child, Preschool
Echocardiography, Transesophageal / instrumentation,  methods*
Female
Heart Atria*
Heart Catheterization / adverse effects,  instrumentation,  methods*
Heart Septal Defects, Atrial / complications*,  therapy*
Hemodynamics
Humans
Hypertrophy, Right Ventricular / etiology*,  physiopathology,  ultrasonography*
Infant
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Regression Analysis
Risk Factors
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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