RT Journal Article
SR Electronic
T1 Similar cardiac remodelling after transcatheter atrial septal defect closure in children and young adults
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 958
OP 962
DO 10.1136/hrt.2005.070169
VO 92
IS 7
A1 G Santoro
A1 M Pascotto
A1 S Caputo
A1 F Cerrato
A1 M Cappelli Bigazzi
A1 M T Palladino
A1 C Iacono
A1 M Carrozza
A1 M G Russo
A1 R Calabrò
YR 2006
UL http://heart.bmj.com/content/92/7/958.abstract
AB Objective: To study the cardiac geometric changes after transcatheter closure of large atrial septal defects (ASDs) according to patient age at the time of the procedure. Design: Prospective echocardiographic follow-up study. Setting: Tertiary referral centre. Patients and intervention: 25 asymptomatic patients younger than 16 years (median 8 years; group 1) and 21 asymptomatic adults (median 38 years; group 2) underwent percutaneous closure of large ASD with the Amplatzer septal occluder device (mean 25 (SD 7) mm). Main outcome measures: Cardiac remodelling was assessed by M mode and two dimensional echocardiography one and six months after ASD closure. Results: By six months, right atrial volume decreased from 31 (15) to 19 (5) ml/m2 (p < 0.001) and right ventricular (RV) transverse diameter decreased from 29.8 (8.6) to 23.2 (5.6) mm/m2 (p < 0.001). Conversely, left atrial volume did not change significantly (from 18 (6) to 20 (6) ml/m2, NS) and left ventricular (LV) transverse diameter increased from 27.8 (6.4) to 31.8 (7.3) mm/m2 (p < 0.05). Ventricular remodelling resulted in an RV:LV diameter ratio decrease from 1.1 (0.2) to 0.7 (0.1) (p < 0.001). The magnitude and time course of cardiac remodelling did not differ significantly between the age groups. Indeed, right atrial volume decreased by 33 (26)% versus 37 (23)%, RV diameter decreased by 26 (10)% versus 20 (13)%, LV diameter increased by 17 (15)% versus 15 (10)%, and RV:LV diameter ratio decreased by 36 (8)% versus 27 (15)% in groups 1 and 2, respectively. Conclusions: Cardiac remodelling after percutaneous ASD closure seems to be independent of the patient’s age at the time of the procedure up to early adulthood. Thus, postponing ASD closure for a few years may be a reasonable option for potentially suitable asymptomatic children.