Comparison of cardiac function in children after surgical and Amplatzer occluder closure of secundum atrial septal defects

Abstract

The aim of the retrospective study was to examine the changes in the left and right ventricular size as well as the systolic and diastolic function of the left ventricle after surgical and transcatheter treatment of atrial septal defects with Amplatzer atrial septal defect occluder (ASDO). Two groups of patients were examined using transthoracic cross-sectional echocardiography before and after the treatment of atrial septal defect: Group A--Amplatzer ASD occluder--38 children and Group S treated surgically--20 children. The following parameters were assessed: left and right ventricular end-diastolic diameter indexes, ejection fraction, mitral E wave to A wave velocity ratio, deceleration time (DCT), isovolumetric relaxation time (IVRT) and heart rate. There was a significant decrease in right ventricular and an increase in left ventricular size in both groups during the follow-up observation. The long-term ECHO examination revealed smaller right ventricle (RV) (Group A: RVEDI=1.00+/-0.20 vs Group S RVEDI: 1.18+/-0.20 (p=0.001)) and bigger left ventricle (Group A: LVEDI=1.04+/-0.08 vs Group S: LVEDI=0.99+/-0.07 (p=0.022)) in Group A in comparison to Group S. Children undergoing operation had significantly shorter IVRT (Group A: IVRT=50.00+/- 9.65 vs Group S: IVRT=42.5+/- 8.95 (p=0.02)) than patients after ASDO device application. (1) During the follow-up period, the diastolic function of the left ventricle is better in children with device closure of ASD compared with those patients treated surgically. (2) Postoperative changes of the left and right ventricular size indexes are more favourable in patients after the device closure of ASD compared with children undergoing the surgical procedure.