Changes in reverse cardiac remodeling after percutaneous atrial septal defect closure in children and adults

Abstract

Background: The influence of the timing of transcatheter atrial septal defect (ASD) closure on ventricular remodeling at 6 months after ASD closure is unclear. This study investigated changes in cardiac remodeling after trans-catheter closure of large ASDs according to patient age at the time of the procedure. Methods: In this study, 41 children and 43 adults underwent percutaneous closure of a large ASD. Cardiac remodeling was assessed by two-dimensional echocardiography and electrocardiography before and at 6 months after ASD closure. Results: The age of the children and adults were 2.8 ± 3.1 and 50.0 ± 15.6 years, respectively. The Qp/Qs ratio of all patients was 2.24 ± 0.67. The right atrial (RA) maximal dimension and right ventricular (RV) transverse diameter were significantly decreased and the left ventricular (LV) dimension was significantly increased at 6 months after ASD closure. However, the difference in RA and RV dimension changes between the groups was not statistically significant. The difference in left atrial (LA) dimension changes between the groups was also not statistically significant, but the LV dimension significantly increased in children compared with that in adults (P = 0.018). The RV/LV ratio was decreased after ASD closure, and a significant difference was found in the RV/ LV ratio changes between the groups. In ECG, the PR interval was significantly more decreased in adults than in children (P = 0.003). Conclusions: In conclusion, the LV diameter was significantly more increased in children than in adults at 6 months after percutaneous ASD closure. Thus, cardiac remodeling after percutaneous ASD closure varies in children and adults.