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The immediate haemodynamic response and right and left cardiac remodelling after percutaneous transcatheter closure of secundum atrial septal defect in children: a longitudinal cohort study

Part of: Echocardiography

Published online by Cambridge University Press:  18 February 2021

Sadettin Sezer ,
Abdullah Özyurt ,
Nazmi Narin ,
Özge Pamukcu Open the ORCID record for Özge Pamukcu [Opens in a new window] ,
Süleyman Sunkak ,
Mustafa Argun Open the ORCID record for Mustafa Argun [Opens in a new window] ,
Ali Baykan Open the ORCID record for Ali Baykan [Opens in a new window]  and
Kazım Üzüm
Sadettin Sezer*
Affiliation:
Department of Pediatric Cardiology Clinic, Gaziantep Cengiz Gökçek Maternity and Children’s Hospital, Gaziantep, Turkey
Abdullah Özyurt
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
Nazmi Narin
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
Özge Pamukcu
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
Süleyman Sunkak
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
Mustafa Argun
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
Ali Baykan
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
Kazım Üzüm
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
*
Author for correspondence: S. Sezer, MD, Department of Pediatric Cardiology Clinic, Gaziantep Cengiz Gökçek Maternity and Children’s Hospital, Gaziantep, Turkey. Tel: +90 5052671318; Fax: +90.342 360 02 90. E-mail: [email protected]
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Abstract

Objective:

We aimed to assess the immediate haemodynamic response and the timing of cardiac remodelling in paediatric secundum atrial septal defect patients who underwent percutaneous transcatheter closure.

Methods:

In this longitudinal cohort study with 41 paediatric secundum ASD patients who underwent PTC with Amplatzer Occluder device were assessed for immediate post-interventional haemodynamic response measured by catheterisation and was evaluated for right and left cardiac remodelling during a follow-up period of 12 months by transthoracic echocardiography. SPSS 20.0 was used for statistical analyses of pre- and post-interventional invasive haemodynamic parameters of the patients, and pre- and post-interventional TTE data compared with the values of the control group consisted of 39 healthy children.

Results:

The mean diameter of ASD was 13.9 ± 4.7 mm. PTC intervention in all patients completed with 100% success and 0% complication rates. All invasive haemodynamic data, except the ratio of pulmonary resistance to systemic resistance, significantly reduced after PTC (p < 0.05). TTE and PW Doppler revealed that right and left cardiac remodelling started as soon as the post-interventional 24th hour and completed in the 12th month.

Conclusions:

This study with a very high interventional success rate can be counted as the first example of research on the haemodynamic response and timing of cardiac remodelling after PTC of secundum ASD in children. We suggest that future multicentric studies with larger cohorts and a comprehensive methodology like ours with longer follow-up periods would better serve to further assess the cardiac remodelling in children after PTC of secundum ASD.

Keywords

Cardiac remodellingpercutaneous transcatheter closureatrial septal defectinvasive haemodynamicscongenital heart disease
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 9 , September 2021 , pp. 1476 - 1483
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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