LEFT ATRIAL SHAPE AND FUNCTION AFTER ENDOVASCULAR DEVICE AND SURGICAL
CLOSURE OF ASDS IN CHILDREN
Abstract
Retrospective analysis of echocardiograms was performed in 756 children
who received endovascular device or surgical ASD closure from 2006 to
2016 in the Cardiac Center in Tomsk Russia. 564 patients had an
endovascular closure and 192 had surgical correction. Follow-up duration
was from 1 day to 10 years, mean 3.6 yrs for the device group and 4.2
yrs for the surgery group. The control group consisted of 3393
age-matched healthy patients. In patients with endovascular closure of
an ASD, 35% had a change in the shape of the left atrium in early
follow-up. Changes in the shape of the left atrium at early follow-up
were more often observed in the device group and in children of a
younger age. The left atrial changes were a decrease in sphericity and
an increase in ellipsoidy. Changes in the shape of the left atrium
persisted in 22% after transcatheter correction in the long-term. The
change in shape of the left atrium after the placement of ASD devices
was accompanied by activation of the mechanical function of the atrium
and an increase in the filling pressure of the left ventricle. These
changes were not accompanied by any disturbance in the contractility and
volume of the heart chambers. In the group with surgical correction of
ASD, the contractility and volume of the heart chambers did not
significantly differ from those in the device closure group.