Changes Of Cardiac Morphology And Left Ventricular Systolic Function After Atrial Septal Defect Closure In Patients With Different Ages

Objective To study the changes of cardiac morphology and left ventricularsystolic function after transcatheter closure of atrial septal defect (ASD) in ASDpatients with different ages in order to observe the effect of age on the prognosisof atrial septal defect closure.Methods Right ventricular end-diastolic diameter (RVEDD), right atriumend-systolic diameter (RAESD), left ventricular end-diastolic diameter(LVEDD), left atrium end-systolic diameter (LAESD) and left ventricularejection fraction (LVEF) of373ASD patients measured before and aftertranscatheter closure for24hours,1month and1year using transthoracicechocardiographic (TTE) were collected. RVEDD/LVEDD were calculated.373patients aged from2to66years old were divided into3study groupsaccording to their ages at the time of the procedure: group A (the minor group，age<18years olds, n=148), group B (the young adult group, age18~39yearsolds, n=154), and group C (the old adult group，age≥40years old, n=71). Thechanges of cardiac morphology and left ventricular systolic function after ASDclosure in each group were analyzed in order to observe the effect of age on the prognosis of ASD closure.Results1. In each group, RVEDD and RVEDD/LVEDD were reducedprogressively as well as LVEDD was enlarged progressively in24hours,1month and1year after operation compared with pre-operation (all P<0.05); Inaddition, RAESD was reduced, LAESD was enlarged and LVEF was increasedcompared with pre-operation (all P<0.05).2. The degree of reduction inRVEDD and RAESD in group A were greater than group B and C at each timepoints (all P<0.05)，but the degree of reduction in RVEDD and RAESD ingroup B were greater than group C only in24hours and1month afteroperation(P<0.05). There was no difference between3groups in the degree ofdecrease in RVEDD/LVEDD in1month and1year after operation (P>0.05).Conclusions1.Transcatheter closure of ASD can cause effective recovery incardiac geometric and improve left ventricular systolic function in patients withdifferent ages. Age has no effect on the globle cardiac remodeling onintermediate and long-term followup; Transcatheter closure of ASD is safe andeffective in all ages.2. Age has effect on the right heart remodeling. The speedof remodeling in right heart decreased with the increase of age, which indicatedthat transcatheter closure must be recommended early after the diagnosis ofhemodynamically significant ASD.3.TTE can observe the changes of cardiacmorphology and function after transcatheter closure termly and repeatedly andplay an important guiding role in clinical for evaluating the prognosis of atrialseptal defect closure.