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Background: Atrial septal defects lead to left to right shunt, the volume of the shunt is determined by RV/LV compliance, defect size, and LA/RA pressure. RV volume overload and pulmonary over circulation are caused by a simple ASD because the RV is more compliant than the LV. The aim of our study was to assess changes in RV systolic function before and after ASD closure either by surgery or transcatheter closure. Methods: This study was conducted on 70 patients diagnosed with ASD Secundum and had subdivided into two groups A (surgical closure) group, and B (percutaneous device closure) group. All patients had been assessed by transthoracic Echocardiography examination for RV systolic Function 24 h before ASD closure, and 6 months after closure. Results: There was a significant decrease in the right ventricle systolic function indices (TAPSE, FAC, Tissue Doppler S wave velocity, and global longitudinal free wall strain) after ASD closure either by surgery or by transcatheter device closure Conclusions: The right ventricle's size and function are affected by a large shunt caused by an ASD secudium. ASD and its consequent volume overload resulted in higher RV myocardial contraction, leading to an increase in strain values and RV systolic function indices, which were reduced and returned to normal values when the left-to-right shunt was eliminated, and the defect was closed.
RESUMEN
Background: The left ventricular (LV) chamber size and its systolic function is the most common and quickest assessment made by echocardiography, either in the intra operative or intensive care setting, being the pressure generator for the blood supply to the body .Congenital cardiac defects come in two main types: atrial and ventricular septal defects (ASD/VSD). Regression or spontaneous closure may be the natural course of minor septal defects. Aim and Objectives: The aim of the study was to assess the feasibility of speckle tracking echocardiography in estimation of left ventricular systolic function in congenital shunt lesions (ASD, VSD and PDA). Subjects and Methods: This study was done in Tanta University Hospital including 270 patients. The patients were divided into four groups: ASD patients, VSD patients, PDA patients and control subjects. Results: It showed statistically significant difference between ASD, PDA and control group. The difference between the PDA group and the control group was statistically significant. There was a statistically significant difference between the ASD group and the control group in terms of EF percent, FS percent, and ESV ROC curve for Validity of GLS to predict LV systolic dysfunction in PDA Group. Sensitivity was 68 and sensitivity was 80. Conclusion: It was determined that Speckle-tracking echocardiography offers an additional non-invasive method for evaluating patients' left ventricular function. With congenital shunt lesions.
RESUMEN
Background: An atrial septal defect (ASD) is a persistent interatrial communication. It is distinct from a patent foramen ovale wherein there is a flap with intermittent communication. The aim of this work was to assess prevalence of mitral valve regurge or prolapse and left atrial volume in patients with secundum type ASD. Methods: This prospective study was carried out at the cardiovascular department, Tanta University Hospitals on 140 patients either adult or children who were diagnosed as atrial septal defect by 2-D echocardiography. They were subjected to detailed history, detailed clinical examination, chest x-ray and echocardiography (2-D echo & Doppler). Results: 95% of patients were trivial or mild mitral regurgitation, 3.6% were moderate and 1.4% were severe. Cause of mitral valve regurgitation was 2.86% prolapse, 1.43% rheumatic and 0.71 dysplastic. Left atrial enlargement was found in 2.1% of patients. Mean LA diameter was 34.68 ± 3.9 mm, mean LA volume was 45.75 ± 3.44 ml and mean LA volume index was 24.14 ± 2.97 ml/m2. 1.43% of patients have history of rheumatic fever. 51.4% of patients presented with fatigue, 45.7% presented with palpitation, 41.4% of the patients presented with exertional dyspnea and 22.8% presented with tachypnea. Conclusions: The prevalence of mitral regurgitation is low in secundum ASD. Mitral regurgitation associated with secundum atrial septal defect could exist as a coexistent lesion, its recognition is important and most of them could be repaired with satisfactory results. Also, the left atrial volume was not affected except in sever mitral regurgitation.