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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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References

Liu, Y, Chen, S, Zühlke, L, et al. Global birth prevalence of congenital heart defects 1970-2017: updates systematic review and meta-analysis of 260 studies. Int J Epid 2019; 48: 455–463.CrossRefGoogle Scholar
Celermajer, DS. Atrial septal defects: even simple congenital heart diseases can be complicated. Eur Heart J 2018; 39: 999–1001.CrossRefGoogle ScholarPubMed
Torres, AJ. Hemodynamic assessment of atrial septal defects. J Thorac Dis 2018; 10 (Suppl 24): S2882–2889.CrossRefGoogle ScholarPubMed
Knop, M, Szkutnik, M, Fiszer, R, Białkowska, B, Głowacki, J, Białkowski, J. Transcatheter closure of atrial septal defect in children up to 10 kg of body weight with Amplatzer device. Cardiol J 2014; 21: 279–283.CrossRefGoogle ScholarPubMed
Ooi, YK, Kelleman, M, Ehrlich, A, et al. Transcatheter versus surgical closure of atrial septal defects in children. JACC Cardiovasc Interv 2016; 9: 79–86.CrossRefGoogle ScholarPubMed
Prieto, LR. Outcomes after device closure of atrial septal defect in children. JACC: Cardiovasc Interv 2018; 11: 805–807.Google ScholarPubMed
Han, Y, Zhang, X, Zhang, F. Transcatheter and intraoperative device closure of atrial septal defect in infants under three years of age. J Cardiothorac Surg 2020; 15: 1–7.CrossRefGoogle ScholarPubMed
Houeijeh, A, Hascoet, S, Bouvaist, H, et al. Transcatheter closure of large atrial septal defects (ASDs) in symptomatic children with device/weight ratio ≥1.5. Int J Cardiol 2018; 267: 84–87.CrossRefGoogle ScholarPubMed
Baykan, A, Pamukcu, O, Ozyurt, A, et al. Is it safe to close ASD with the guidance of transthoracic echocardiography in pediatric population: “ten years’ experience of a single center”. J Interv Cardiol 2015; 28: 172–179.CrossRefGoogle Scholar
O’Bryne, ML, Levi, DS. State of the art ASD closure devices for congenital heart. Interv Cardiol Clin 2019; 8: 11–21.Google Scholar
Castaldi, B, Vida, VL, Argiolas, A, et al. Late electrical and mechanical remodeling after atrial septal defect closure in children: Surgical versus percutaneous approach. Ann Thorac Surg 2015; 100: 181–186.CrossRefGoogle ScholarPubMed
Narin, N, Baspinar, O, Pamukcu, O, et al. Percutaneous ASD closure of children weighing less than 10 kg. Acta Cardiol 2019; 3: 1–6.Google Scholar
Jategaonkar, SR, Scholtz, W, Butz, T,Bogunovic, N, Faber, L, Horstkotte, D. Two-dimensional strain and strain rate imaging of the right ventricle in adult patients before and after percutaneous closure of atrial septal defects. Eur J Echocardiogr 2009; 10: 499–502.CrossRefGoogle ScholarPubMed
Balci, KG, Balci, MM, Aksoy, MM, et al. Remodeling process in right and left ventricle after percutaneous atrial septal defect closure in adult patients. Arch Turk Soc Cardiol 2015; 43: 250–258.CrossRefGoogle ScholarPubMed
Akula, VS, Durgaprasad, R, Velam, V, Kasala, L, Rodda, M, Erathi, HV. Right ventricle before and after atrial septal defect device closure. Echocardiograhy 2016; 33: 1381–1388.CrossRefGoogle ScholarPubMed
Stephensen, SS, Ostenfeld, E, Kutty, S, et al. Transcatheter closure of atrial septal defect in adults: time-course of atrialand ventricular remodeling and effects on exercise capacity. Int J Cardiovasc Imag 2019; 35: 2077–2084.CrossRefGoogle ScholarPubMed
Mainzer, G, Braver, Y, Khoury, A, et al. Morphologic, Mechanical, Conductive, and hemodynamic changes following transcatheter closure of atrial septal defect. Congenit Heart Dis 2010; 5: 25–31.CrossRefGoogle ScholarPubMed
Tashiro, H, Suda, K, Iemura, M, Teramachi, Y. Intergenerational differences in the effects of transcatheter closure of atrial septal defects on cardiac function. J Cardiol 2017; 70: 620–626.CrossRefGoogle ScholarPubMed
Yoo, BW, Kim, JO, Eun, LY, Choi, JY, Dong, SK. Time course of the changes in right and left ventricle function and associated factors after transcatheter closure of atrial septal defects. Congenit Heart Dis 2017; 13: 131–139.CrossRefGoogle ScholarPubMed
Lopez, L, Colan, SD, Frommelt, PC, et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram: A report from the pediatric measurements writing group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Soc Echocardiogr 2010; 23: 465–495.CrossRefGoogle ScholarPubMed
Anavekar, NS, Skali, H, Bourgoun, M, et al. Usefulness of right ventricular fractional area change to predict death, heart failure, and stroke following myocardial infarction (from the VALIANT ECHO study). Am J Cardiol 2008; 101: 607–612.CrossRefGoogle Scholar
Ammar, A, Arab, TMA, Hammady, WAE, Sayed, MHE. Intermediate outcome of transcatheter closure of secundum atrial septal defect on cardiac remodeling in Egyptian children and adults. J Cardiol Curr Res 2016; 6: 00224.Google Scholar
Cao, Q, Du, Z, Joseph, A, et al. Immediate and six-month results of the profile of the amplatzer septal occluder as assessed by transesophageal echocardiography. Am J Cardiol 2001; 88: 754–759.CrossRefGoogle ScholarPubMed
Jalal, Z, Hascoet, S, Gronier, C, et al. Long-term outcomes after percutaneous closure of ostium secundum atrial septal defect in the young. JACC: Cardiovas Interv 2018; 11: 795–804.Google Scholar
Behjati, M, Mirhosseini, S, Hosseini, S, Rajaei, S. Transcatheter closure of atrial septal defect with Amplatzer device in children and adolescents: Short and Midterm results; an Iranian Experience. Iran J Pediatr 2011; 21: 166–172.Google Scholar
Yilmazer, MM, Guven, B, Vupa-Cilengiroglu, O, et al. Improvement in cardiac structure and functions early after transcatheter closure of secundum atrial septal defects in children and adolescents. Turk J Pediatr 2013; 55: 401–410.Google ScholarPubMed
Wyss, Y, Quandt, D, Weber, R, et al. Interventional closure of secundum type atrial septal defects in infants less than 10 kilograms: indications and procedural outcome. J Interv Cardiol 2016; 29: 646–653.CrossRefGoogle ScholarPubMed
Knop, MT, Bialkowski, J, Szkutnik, M, et al. Transcatheter closure of atrial septal defects type 2 in children under three years of age. Kardiologia Polska 2018; 76: 1257–1262.CrossRefGoogle ScholarPubMed
Xu, Q, Sun, L, Zhou, W, et al. Evaluation of right ventricular myocardial strains by speckle tracking echocardiography after percutaneous device closure of atrial septal defects in children. Echocardiography 2018; 35: 1183–1188.CrossRefGoogle ScholarPubMed
Agha, HM, El-Saiedi, SA, Shatout, MF, et al. Incomplete RV remodeling after transcatheter ASD closure in pediatric age. Pediatr Cardiol 2015; 36: 1523–1531.CrossRefGoogle ScholarPubMed
OBryne, ML, Kennedy, KF, Rome, JJ, Glatz, AC. Variation in practice patterns in device closure of atrial septal defects and patent ductus arteriosus: An analysis of data from the IMPACT Registry. Am Heart J 2018; 196: 119–130.Google Scholar