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.