Comparison of the Response of the Right Ventricle with Endovascular Occlusion and Surgical Closure in Adults with Atrial Septal Defect One Year after Intervention

Abstract

Background Use of the Amplatzer septal occluder (ASO) for the closure of secundum atrial septal defect (ASD) has recently become the procedure of choice, while earlier the only treatment for ASD was surgical closure. This study compares the right ventricular indices of the ASO group with the surgical closure group one year after intervention in adults. Methods From January 2008 to February 2010, 38 patients with isolated atrial septal defect of the secundum type one year after surgical (n = 20, age = 27 ± 4 years, 13 females, 7 males) or Amplatzer septal occluder closure (n = 18, age = 25 ± 4 years, 12 females, 6 males) were studied. At the same time, thirty-one age-matched normal subjects (age = 26 ± 6 years, 23 females, 9 males) were included as the control group. Strain and strain rate of the right ventricle were measured. Results The mean values of strain of the midportion were −26% ± 11.7%, −8.9% ± 4.2%, and 24.5% ± 7.4% ( P < 0.001). Strain rates of the midportion were −2.19 ± 0.6 s−1, −1.2 ± 0.4 s−1, −1.9 ± 0.6 s−1 ( P < 0.001) in ASO, surgery, and control groups, respectively. Conclusion This study showed that the right ventricle might show better performance in the ASO than the surgery group in adults with ASD in midterm follow-up.