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继发孔型房间隔缺损封堵术后经胸超声心动图检查结果:一项为期六个月的随访研究。

Trans-thoracic echocardiographic findings after the closure of ostium secundum atrial septal defect: A six-month follow-up study.

作者信息

Bigdelu Leila, Nezhad Biglari Naser, Ghaderi Yoones, Azari Ali, Emadzadeh Maryam, Moohebati Mohsen, Azadi Nadia, Baradaran Rahimi Vafa

机构信息

Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

J Cardiovasc Thorac Res. 2025 Mar 18;17(1):27-34. doi: 10.34172/jcvtr.025.32997. eCollection 2025 Mar.

Abstract

INTRODUCTION

Adults with an atrial septal defect (ASD) have the third most frequent congenital heart disease. We aimed to determine the echocardiography findings after the defect closure in patients with ostium secundum ASD.

METHODS

We included patients who underwent the closure of ostium secundum ASD using trans-catheter or surgical procedures. All patients were subjected to transthoracic echocardiography at admission, one month, and six months following successful closure. The remaining shunt were measured using contrast echocardiography and none of our patients had the remaining shunt.

RESULTS

We evaluated 28 patients with a mean age of 35.67±11.55 years. Twelve (42.85%) individuals had trans-catheter, and 16 (57.14%) patients had surgical closure of ASD. After ASD closure, the left ventricular (LV) ejection fraction (=0.02), and LV end-diastolic diameter significantly increased while S'_TAPSE, right atrial (RA) area, RA volume, and pulmonary artery pressure (PAP) markedly diminished (<0.001). During follow-up, RV size changes showed a significant decrease during one (17.93%) and six (25.78%) months (<0.001 for both cases) and become normal following six months after the ASD closure. In addition, the RA/LA area ratio dropped by 24.31% during the first month and 33.17% after six months (<0.001). In addition, the changes in measured echocardiographic parameters were not significantly different over time between the trans-catheter and surgical procedures. The decrease in S'_TAPSE was significantly greater in the surgical group than in trans-catheter closure.

CONCLUSION

Closure of ostium secundum ASD dramatically decreased right cardiac chamber size and PAP while enhancing LV diameter and LV ejection fraction.

摘要

引言

房间隔缺损(ASD)的成年患者患先天性心脏病的频率位列第三。我们旨在确定继发孔型ASD患者缺损闭合后的超声心动图表现。

方法

我们纳入了采用经导管或外科手术闭合继发孔型ASD的患者。所有患者在入院时、成功闭合后1个月和6个月接受经胸超声心动图检查。使用对比超声心动图测量残余分流,我们的患者均无残余分流。

结果

我们评估了28例患者,平均年龄为35.67±11.55岁。12例(42.85%)患者采用经导管封堵,16例(57.14%)患者采用外科手术闭合ASD。ASD闭合后,左心室(LV)射血分数(=0.02)和LV舒张末期直径显著增加,而S'_TAPSE、右心房(RA)面积、RA容积和肺动脉压(PAP)明显减小(<0.001)。在随访期间,右心室大小在1个月(17.93%)和6个月(25.78%)时显著减小(两种情况均<0.001),并在ASD闭合后6个月恢复正常。此外,RA/LA面积比在第1个月下降了24.31%,6个月后下降了33.17%(<0.001)。此外,经导管和外科手术两组间测量的超声心动图参数随时间的变化无显著差异。外科手术组S'_TAPSE的下降显著大于经导管封堵组。

结论

继发孔型ASD的闭合显著减小了右心腔大小和PAP,同时增加了LV直径和LV射血分数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95bf/12068796/939cc31564b0/jcvtr-17-27-g001.jpg

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