Impact of transcatheter closure of atrial septal defects on cardiac function.

Purpose: The purpose of this study was to investigate the effects of transcatheter closure of atrial septal defects (ASD) on left ventricular function.

Methods: Conventional and three-dimensional echocardiographic methods (3D) were performed in 20 patients who underwent ASD closure. Diastolic and systolic volumes (LVVd and LVVs) and ejection fractions (EF) were determined by 3D methods. Doppler and tissue Doppler indices were also measured before and 1 day after the procedure. We determined the predictors of patients with a mitral early Doppler/tissue Doppler velocity ratio (E/E') ≥8 after closure.

Results: Ejection fraction decreased (from 70 ± 8 to 63 ± 8%, p = 0.005) after the procedure because of an equivalent increase in LVVs and LVVd maintaining the same cardiac output. Among the echocardiographic variables before ASD closure that correlated with E/E' after closure, the receiver operating characteristic curve of E' gave the largest area under the curve with E' of 12.2 cm/s as the best predictor of patients with E/E' ≥8 after ASD closure.

Conclusion: Atrial septal defect closure decreased EF on the surface, thereby maintaining the same stroke volume and cardiac output. Patients with diastolic dysfunction before closure might have a higher risk of developing congestive heart failure after ASD closure.