VENTRICULAR REVERSE REMODELING AFTER SURGICAL CLOSURE IN ATRIAL SEPTAL DEFECT
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 46
Abstract
BACKGROUND Isolated ASD is the second most common form of congenital heart disease presenting in childhood. There is increase in Right Ventricular (RV) diastolic and RA dimensions due to volume overload. Adults with haemodynamically significant ASD have subnormal LV diastolic dimension. The medium and long-term followup of patients with ASD closure show excellent results. Studies have shown haemodynamic and functional improvement in RV and LV function after surgical closure of ASD. Even though the long-term remodelling changes after surgical closure of ASD is well understood, the short-term remodelling and haemodynamic changes are not well documented. The present study is aimed at documenting short-term remodelling and haemodynamic changes after surgical closure of ASD. MATERIALS AND METHODS Data collected from 70 consecutive patients admitted for surgical closure of Atrial Septal Defect (ASD). Patients were divided into two groups- Group I ≤ 12 years of age and Group II > 12 years of age. The post-operative course of patients in the hospital were observed and clinical and echocardiographic evaluation were done on the day of discharge from the hospital. Then at a threemonth followup visit, detailed clinical, ECG, radiologic and echo evaluation were done. Data obtained were coded and entered into Microsoft Excel spreadsheet and analysed using Statistical Package for Social Sciences (SPSS) version 16 for Windows. Description of sociodemographic characteristics, clinical features and echocardiographic features were done in terms of frequencies and percentages. Continuous parameters were represented by mean SD. Association of study outcome with other factors were found out by using chi-square test. Fisher exact test was used instead of chi-square test when expected frequencies were considerably small. A P value of < 0.05 was considered to be a statistically significant result. RESULTS Most of the patients in the study population had elevated pre-operative RV dimensions. During post-operative period of ASD closure, the RV size decreased dramatically and RV wall motion became normal; another striking change is noticed in association with Tricuspid Annular Motion (TAM). There was a significant reduction in RVSP in both groups. There was a significant increase in LVIDd in both the groups after ASD closure. CONCLUSION Echocardiographic evaluation at discharge and at 3 months revealed significant reduction in diastolic dimensions of right ventricle. There was significant increase in transmitral (mitral E) flow velocity. The tricuspid annular motion showed significant reduction in both groups following ASD closure, probably due to reduction in right ventricular volume overload.
Authors and Affiliations
Cicy Bastian, Jayaram Vasu, Devarajan Karimpanmavil Ayyappan, Sudhayakumar N
Keywords
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- EP ID EP217347
- DOI 10.14260/Jemds/2017/770
- Views 51
- Downloads 0
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