Reverse Remodeling of Right Cardiac Chambers After Percutaneous Atrial Septal Defect Closure

• Type: Summary of Presentation in an International Conference
• Date: 2012

Authors

Sousa A (Author) Other; Lebreiro A (Author) Other; Correia AS (Author) Other; Cruz C (Author) Other; Almeida P (Author) Other; Oliveira NP (Author) Other; Silva JC (Author) Other; Macedo F (Author) Other; Maciel MJ (Author) FMUP

Conference proceedings International

Title: European Journal of Heart Failure Supplements

Initial page: P1407

Heart Failure Congress 2012

Belgrade, 2012

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Abstract (EN): Introduction: Right cardiac chambers volume overload due to atrial septal defect (ASD) is associated with right ventricular (RV) failure.The timing for right chambers size normalization after ASD closure and their determinants are not well known. We aimed to determine variables that may identify patients (pts) likely to have greater improvement after ASD percutaneous closure. Methods: Pts followed at an Adult Congenital Heart Disease Clinic, who underwent successful percutaneous ASD closure, between June 2007 and May 2011, were retrospectively evaluated. Clinical and echocardiographic data at 1 and 6 months after intervention were reviewed. Results: We analyzed 23 pts, mean age 42±15 years (y), 61% women. All pts had preserved RV systolic function. Mean ASD size was 17±6 mm and septal occluder size was 19±6 mm. Mean Qp/Qs was 2.0±0.8 and mean pulmonary artery systolic pressure (PASP) 28±9 mmHg, by invasive evaluation. At baseline, 5 (22%) and 9 (39%) pts showed moderate RV and right atrial (RA) dilatation, respectively, and the remaining pts had mild right chamber dilatation. Pts with moderate RV dilatation were younger (28±10 vs 46±14y, p0.007), with larger ASD (21±6 vs 15±6mm, p0.027) and higher echocardiographic PASP (52±9 vs 37±8 mmHg, p0.011). Pts with moderate RA dilatation had also higher echocardiographic PASP (51±8 vs 34±7mmHg, p0.001). Echocardiographic data was available in 18 pts. At 1-month, 12 pts (67%) had normal RV size and 12 (67%) had normal RA size. Pts with RA size normalization were significantly younger (36±15 vs 53±10y, p0.035). At 6-months, also 12 pts (67%) had normal RV and RA size. Pts with RV size normalization were those with smaller ASD (14±5 vs 22±5 mm, p0.014) and implanted a smaller septal occluder device (18±5 vs 24±4mm, p0.022). In a model of logistic regression, only a lower ASD size was predictor of a higher probability of RV normalization [OR 1.3 (95%CI 1.01-1.64)]. Conclusion: Soon (at first month) after percutaneous ASD closure most pts normalize right cardiac chambers dimensions. Simple clinical and echocardiographic data may be of value in predicting right chamber ventricular reverse remodeling.

Language: English

Type (Professor's evaluation): Scientific

Notes: Sousa, A. Lebreiro, AS. Correia, C. Cruz, P. Almeida, N. Pardal Oliveira, F. Macedo, J.C. Silva, MJ. Maciel. Reverse Remodeling of Right Cardiac Chambers After Percutaneous Atrial Septal Defect Closure. Eur J Heart Fail Suppl 2012; 11(Suppl 1): P1407. ISSN 1567-4215. Heart Failure Congress 2012, Belgrade, 2012