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Transcatheter closure of atrial septal defects improves right ventricular volume, mass, function, pulmonary pressure, and functional class: a magnetic resonance imaging study
  1. S P Schoen1,
  2. T Kittner2,
  3. S Bohl1,
  4. M U Braun1,
  5. G Simonis1,
  6. A Schmeisser1,
  7. R H Strasser1
  1. 1Department of Cardiology, University of Dresden, Dresden, Germany
  2. 2Department of Radiology, University of Dresden, Dresden, Germany
  1. Correspondence to:
    Dr Med Steffen P Schoen
    Department of Cardiology, Heart Centre, University of Dresden, Fetscherstrasse 76, 01307 Dresden, Germany; cardiology{at}email.de

Abstract

Objective: To characterise prospectively by magnetic resonance imaging (MRI) changes in right ventricular (RV) volume, function, and mass after transcatheter closure of atrial septal defects (ASDs) and to evaluate the course of pulmonary pressure and functional class criteria.

Methods: In 20 patients with secundum-type ASD and dilated RV diameter, MRI was performed to quantify RV end diastolic (RVEDV) and end systolic volumes (RVESV), RV mass, tricuspid annular diameter, and RV ejection fraction before and 6 and 12 months after transcatheter closure of the ASD. RV systolic pressure was measured during follow up by transthoracic echocardiography.

Results: Functional class improved in the majority of patients after ASD closure. RVESV (from 81 (18) ml/m2 to 53 (15) ml/m2, p < 0.001), RVEDV (from 127 (17) ml/m2 to 99 (18) ml/m2, p < 0.001), and RV mass (from 79 (10) g to 63 (8) g, p < 0.01) decreased significantly during follow up, although tricuspid annular diameter did not. RV ejection fraction improved (by 9% compared with baseline, p < 0.05) and RV systolic pressure decreased significantly (from 33 (8) mm Hg to 24 (6) mm Hg, p < 0.001) after closure.

Conclusion: MRI studies showed significant improvement of RV volumes, mass, and function after transcatheter closure of ASDs. Restoration of the RV leads to decreased pulmonary pressure resulting in a better functional class in the majority of patients.

  • ASD, atrial septal defect
  • LV, left ventricular
  • MRI, magnetic resonance imaging
  • NYHA, New York Heart Association
  • RV, right ventricular
  • RVEDV, right ventricular end diastolic volume
  • RVEF, right ventricular ejection fraction
  • RVESV, right ventricular end systolic volume
  • RVSP, right ventricular systolic pressure
  • TAD, tricuspid annular diameter
  • TOE, transoesophageal echocardiography
  • TR, tricuspid regurgitation
  • TTE, transthoracic echocardiography
  • atrial septal defect
  • transcatheter closure
  • right ventricle
  • magnetic resonance imaging

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Footnotes

  • Published Online First 11 November 2005

  • S P Schoen and T Kittner contributed equally to this manuscript

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