Influence of transcatheter closure for atrial septal defects on heart remodeling and ventricular function in patients at different ages / 中国组织工程研究

ABSTRACT

OBJECTIVE: To investigate the geometric changes and ventricular function of heart after percutaneous closure of atrial septal defect according to patient age at the time of the procedure. METHODS: A total of 109 patients with atrial septal defect admitted to Department of Cardiology, Guizhou Provincial People's Hospital between June 1998 and October 2008 were retrospectively analyzed, including 53 males and 56 females aged 3.5-70 years. According to their age, the patients were divided into child group (aged=7 years, n=31), adolescent group (n=42, aged 8 18years) and adult group (n=36, aged > 18 years). Cardiac remodeling was assessed by transthoracic echocardiography before ASD closure and 6 months after atrial septal defect closure, including lateral diameter of left and right atrium (LALD, RALD), ratio of LALD/RALD, diastolic diameter of left and right ventricle (LVDD, RVDD), RVDD/LVDD ratio, and pulmonary diameter (PD), ejection fraction (EF) of LV and RV. RESULTS: 109 patients were all included in final analysis. Compared with preoperative results, the right atrium, RALD, RVDD,RALD/LALD, RVDD/LVDD ratio and PD were significantly decreased, while the left atrium and LALD significantly increased,and EF of left and right atrium was remarkably improved 6 months following atrial septal defect closure (P< 0.05-0.01).Moreover, the heart remodeling and heart function amelioration after atrial septal defect closure of child group were better than adolescent and adult groups (P < 0.05), but there were no significant differences between adolescent and adult groups (P>0.05).CONCLUSION: Transcatheter closure of atrial septal defect is safe and effective for all patients of different ages; in particular,results at children stage are better than adolescent and adult stages.