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Comparison of acute effects on right ventricular haemodynamics of surgical versus interventional closure of atrial septal defects

Published online by Cambridge University Press:  19 August 2008

F. Berger ,
Z. Jin ,
K. Ishihashi ,
M. Vogel ,
P. Ewert ,
V. Alexi-Meshkishvili ,
Y. Weng  and
P. E. Lange
F. Berger
Affiliation:
Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
K. Ishihashi
Affiliation:
Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
M. Vogel*
Affiliation:
Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
P. Ewert
Affiliation:
Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
V. Alexi-Meshkishvili
Affiliation:
Department of Cardiac Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany
Y. Weng
Affiliation:
Department of Cardiac Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany
P. E. Lange
Affiliation:
Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
*
Professor Michael Vogel, Deucsches Herzzentrum, Augustenburger Platz 1, D-13353 Berlin, Germany. Tel: +49 30 4593 2820; Fax: +49 30 4593 2826; e-mail: mvogel@dhzb.de
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Abstract

Objectives

We compared the acute effects on right ventricular haemodynamics of surgical versus transcatheter closure of medium-sized atrial septal defects.

Methods

We studied 47 consecutive patients with a defect in the oval fossa and a ratio of pulmonary to systemic flows between 1.5: 1 and 2: 1. They were divided into two groups according to whether the defects were closed by surgery, performed in 23 patients, or by interventional catheterization, achieved in 24 patients. By means of transthoracic cross-sectional echocardiography, we measured right ventricular end-diastolic and endsystolic volumes and calculated ejection fractions. These calculations were performed before, and between 1 and 7 days after closure of the defect.

Results

Before closure of the defect, all patients had an enlarged right ventricle with normal function. After closure by either method, there was no difference in the rate of normalization of end-diastolic volume, but endsystolic volume remained enlarged. Thus, the calculated ejection fraction was lower than before closure.

Conclusions

There was no difference in right ventricular volumes or function early after closure of atrial septal defects, irrespective of whether this was achieved surgically or via transcatheter closure.

Keywords

Atrial septal defectechocardiographyright ventricular function
Type
Original Articles
Information
Cardiology in the Young , Volume 9 , Issue 5 , September 1999 , pp. 484 - 487
Copyright
Copyright © Cambridge University Press 1999

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