Assessment of right atrial and right ventricular size in children after percutaneous closure of secundum atrial septal defect with Amplatzer Septal Occluder

The aim of this study was to evaluate right atrial (RA) and right ventricular (RV) size and the speed of normalization of RA and RV size in children after percutaneous closure of secundum atrial septal defect with Amplatzer septal occluder. Methods: The study group consisted of 42 children, aged 4.5 to 18.5 years. The following measurements (indexed to body surface area) were performed using 2D echocardiography: longitudinal, transverse axis and area of RA, RV inflow dimensions at one-third, and halfway between the tricuspid annulus and the apex (in the apical 4-chamber view), short axis and M-mode RV diastolic dimensions. All measurements were obtained: 24 hours, 1, 3, 12 months after the procedure, then annually over 4 years follow-up and compared with the values obtained from the control groups. Results: A significant decrease in all RA and RV values was observed after 24 hours. RV transverse dimension normalized after one month, the RA longitudinal axis and area and the RV inflow dimensions after three months, and the RA transverse axis and M-mode RV diastolic dimension after two years but the ratio of transverse to longitudinal RA axis remained significantly higher. Conclusions: 1. Right atrial and right ventricular measurements decrease rapidly during the first 24 hours, and most of them normalize within three-months period. 2. M-mode RV diastolic dimension do not capture the real RV changes. 3. The Amplatzer septal occluder closure of ASD influences the RA geometry which is reflected by the higher transverse to longitudinal RA axis ratio.

Keywords: atrial septal defect, Amplatzer Septal Occluder, children