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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: [email protected]
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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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References

1.King, TD, Thompson, SL, Steiner, C, Mills, NL. Secundum atrial septal defect: nonoperative closure during cardiac catheterization. J AmMedAss 1976; 235: 2506–2509.Google ScholarPubMed
2.Rome, JJ, Kean, JF, Perry, SB, Spevak, PJ, Lock, JE. Double umbrella closure of atrial septal defects: initial clinical applications. Circulation 1990; 82: 751–758.CrossRefGoogle ScholarPubMed
3.Sideris, EB, Sideris, SE, Thanopoulos, BD, Ehly, RL, Fowlkes, JP. Transvenous atrial septal defect occlusion by the buttoned device. Am J Cardiol 1990; 66: 1524–1526.CrossRefGoogle ScholarPubMed
4.Das, GS, Voss, G, Jarvis, G, Wyche, K, Gunther, R, Wilson, RF. Experimental atrial septal defect closure with a new transcatheter, self-centering device. Circulation 1993; 88:1754–1764.CrossRefGoogle ScholarPubMed
5.Pavcnik, D, Wright, KC, Wallace, S. Monodisk device for percutaneous transcatheter closure of cardiac septal defects. Cardiovasc Intervent Radiol 1993; 16: 308–312.CrossRefGoogle ScholarPubMed
6.Hausdorf, G, Schneider, M, Franzbach, B, Kampmann, C, Kargus, K, Goeldner, B. Transcatheter closure of secundum atrial septal defects with the atrial septal defect occlusion system (ASDOS): initial experience in children. Heart 1996; 76: 83–88.CrossRefGoogle Scholar
7.Jin, Z, Briedigkeit, W, Gamillscheg, A, Berger, F, Skinner, JR, Golshahi, F, Uhlemann, F, Lange, PE. Cross-sectional echocardiographic determination of right ventricular volume and myocardial mass. Normal values and values in children with interatrial communication. Cardiol Young 1997; 7: 302–309.CrossRefGoogle Scholar
8.Berger, F, Lange, PE, Rey, C. The over the wire placement of the buttoned device for occlusion of atrial septal defects: improved international results. Cardiol Young 1995; 5 (suppl.): 1.Google Scholar
9.Boutin, C, Musewe, NN, Smallhorn, JF, Dyck, DJ, Kobiyashi, T, Benson, LN. Echocardiographic follow-upof attial septal defect after catheter closure by double-umbrella device. Circulation 1993; 88: 621–627.CrossRefGoogle Scholar
10.Huysmans, HA, Vrakking, M, van Boven, WJP. Late follow-up after surgical closure of atrial septal defect of the secundum type. Z Kardiol 1989; 78 (suppl. 7): 43–45.Google Scholar
11.Gatzoulis, M, Redington, AN, Somerville, J, Shore, DJ. Should atrial septal defects in adults be closed? Ann Thorac Surg 1996; 61:657–659.CrossRefGoogle ScholarPubMed
12.Vogel, M, Gutberlet, M, Dittrich, S, Hosten, N, Lange, PE. Comparison of transthoracic three-dimensional echocardiography with magnetic tesonance imaging in the assessment of right ventricular volume and mass. Heart 1997; 78:127–130.CrossRefGoogle Scholar
13.Masura, J, Gavora, P, Formanek, A, Hijazi, ZM. Transcatheter closure of atrial septal defects using the new self-centering Amplatzer septal occludet: initial human experience. Cath Cardiovasc Diagn 1997; 42: 388–393.3.0.CO;2-7>CrossRefGoogle ScholarPubMed
14.Berger, F, Ewert, P, Stiller, B, Dähnert, I, Krings, G, Vogel, M, Lange, PE. Initiale klinische Erfahrungen mit dem Amplatzer Septal Occluder: ein selbstzentrierendes Doppelschirmchen zum Verschlu β des Vorhofseptumdefektes. Z Kardiol 1998; 87: 185–190.Google Scholar