Long term outcome after surgical ASD-closure at young age: Longitudinal follow-up up to 50 years after surgery

Kauling, Robert M.; Pelosi, Chiara; Cuypers, Judith A.A.E.; van den Bosch, Annemien E.; Hirsch, Alexander; Carvalho, João G.; Bowen, Daniel J.; Kardys, Isabella; Bogers, Ad J.J.C.; Helbing, Wim A.; Roos-Hesselink, Jolien W.

doi:10.1016/j.ijcard.2023.131616

International Journal of Cardiology

2024

DOI: 10.1016/j.ijcard.2023.131616

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Long term outcome after surgical ASD-closure at young age: Longitudinal follow-up up to 50 years after surgery

Robert M. Kauling,

Chiara Pelosi,

Judith A.A.E. Cuypers

et al.

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Cited by 3 publications

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Patients with surgically repaired ASD in childhood: living happily ever after?

González-Fernández,

Dos-Subirà

2024

International Journal of Cardiology

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Patients with surgically repaired ASD in childhood: living happily ever after?

González-Fernández,

Dos-Subirà

2024

International Journal of Cardiology

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Congenital Heart Disease Surgery in Low-Resource Settings

Zheleva,

Zühlke

2024

JACC: Advances

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Atrial septal defect closure in children at young age is beneficial for left ventricular function

Sjöberg,

Clausen,

Arheden

et al. 2024

European Heart Journal - Imaging Methods and Practice

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Aims Atrial septal defects (ASD) lead to volume-loaded right ventricles (RV). Atrial septal defect closure does not always improve symptoms or exercise capacity, possibly explained by impaired left ventricular (LV) hemodynamics. The study evaluated the effect of ASD closure in children using non-invasive LV pressure-volume (PV) loops derived from cardiac magnetic resonance imaging (CMR) and brachial blood pressure, compared with controls. Methods and Results Twenty-three children with ASD underwent CMR, 17 of these were re-examined 7 [6–9] months after ASD closure. Twelve controls were included. Hemodynamic variables were derived from PV loops by time-resolved LV volumes and brachial blood pressure. After ASD closure, LV volume increased (76 [70–86] ml/m2 vs 63 [57–70] ml/m2, p=0.0001), however was still smaller than in controls (76 [70–86] ml/m2 vs 82 [78–89] ml/m2, p=0.048). Compared to controls, children with ASD had higher contractility (2.6 [2.1–3.3] mmHg/ml vs 1.7 [1.5–2.2] mmHg/ml, p=0.0076) and arterial elastance (2.1 [1.4–3.1] mmHg/ml vs 1.4 [1.2–2.0] mmHg/ml, p=0.034). After ASD closure, both contractility (2.0 [1.4–2.5] mmHg/ml, p=0.0001) and arterial elastance (1.4 [1.3–2.0] mmHg/ml, p=0.0002) decreased. Conclusions Despite the left-to-right atrial shunt that leads to low LV filling and RV enlargement, the LV remains efficient and there is no evidence of impaired LV hemodynamics in children. Closure of ASD at young age while the ventricle is compliant is thus beneficial for LV function. Left ventricular volumes however remained small after ASD closure, which may impact long-term cardiovascular risk and exercise performance.

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Long term outcome after surgical ASD-closure at young age: Longitudinal follow-up up to 50 years after surgery

Cited by 3 publications

References 40 publications

Patients with surgically repaired ASD in childhood: living happily ever after?

Patients with surgically repaired ASD in childhood: living happily ever after?

Congenital Heart Disease Surgery in Low-Resource Settings

Atrial septal defect closure in children at young age is beneficial for left ventricular function

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