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Echocardiographic Evaluation of Changes in Cardiac Hemodynamics and Loading Conditions after Transthoracic Minimally Invasive Device Closure of Atrial Septal Defect.

Chen Q, Sun XD, Cao H, Zhang GC, Chen LW, Hu YN - PLoS ONE (2015)

Bottom Line: One week after the procedure, the right ventricular fractional area change, three-dimensional right ventricular ejection fraction, right ventricular Tei index and tricuspid annular plane systolic excursion had significantly reduced compared with the preoperative data (P<0.05).While these four parameters were still decreased at the 3 months and at 1 year's follow-up, but the differences were not statistically significant compared with the 1 week's postoperative data (P>0.05).One week post-procedure, left ventricular ejection fraction had not changed significantly, but at 3 months and at 1 year post-procedure, left ejection fraction had increased significantly compared with the preoperative data (P<0.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, P. R. China.

ABSTRACT

Purpose: To evaluate transthoracic minimally invasive device closure of atrial septal defects by performing transthoracic echocardiography to measure changes in cardiac hemodynamics and loading conditions.

Methods: Between January 2012 and December 2012, we performed transthoracic minimally invasive device closure of atrial septal defects in 95 patients with secundum atrial septal defects (ASD), and performed transthoracic echocardiography to measure blood flow velocities at the tricuspid valve orifice and at the pulmonary valve orifice, sizes of the left and right atria and ventricles, right ventricular fractional area change, right ventricular Tei index, three-dimensional right ventricular ejection fraction, tricuspid annular plane systolic excursion and left ventricular ejection fractions before the procedure and 1 week, 3 months, and 1 year post-procedure.

Results: Varying degrees of improvement were observed post-procedure at later time points. The maximum blood flow velocity at the pulmonary valve orifice, mean flow velocity, velocity-time integral, and A peak and E peak blood flow velocity at the tricuspid valve orifice decreased significantly post-procedure (P<0.05). In 3 months and 1 year's follow-up, the inner diameter of the middle portion of the pulmonary artery, and diameters of the right atrium and right ventricle decreased significantly post-procedure (P<0.05). The diameters of the left atrium and left ventricle increased after the procedure (P<0.05). One week after the procedure, the right ventricular fractional area change, three-dimensional right ventricular ejection fraction, right ventricular Tei index and tricuspid annular plane systolic excursion had significantly reduced compared with the preoperative data (P<0.05). While these four parameters were still decreased at the 3 months and at 1 year's follow-up, but the differences were not statistically significant compared with the 1 week's postoperative data (P>0.05). One week post-procedure, left ventricular ejection fraction had not changed significantly, but at 3 months and at 1 year post-procedure, left ejection fraction had increased significantly compared with the preoperative data (P<0.05).

Conclusion: Echocardiographic evaluation has demonstrated that cardiac hemodynamics and loading conditions improved significantly after transthoracic minimally invasive device closure of atrial septal defects.

No MeSH data available.


Related in: MedlinePlus

Final image shown after both discs were deployed.
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pone.0128475.g002: Final image shown after both discs were deployed.

Mentions: The locations, sizes, and margins of atrial septal defects were identified using transthoracic echocardiography prior to the procedure for screening cases for the study. (Fig 1) [5–7] An appropriately sized occluder (which was manufactured at Dong Guan Ke Wei Medical Apparatus Co. Ltd. of China) was selected according to the preoperative echocardiography measurement, and was placed in the delivery sheath after soaking in heparin saline. During the procedure, under the guidance of a parasternal ultrasonographic 4-chamber view, the delivery sheath was placed into the left atrium through the ASD. Then, via the sheath, the occluder inside the left atrium was opened, and it was then pulled back tightly. Thereafter, the occluder inside the right atrium was opened. (Fig 2) After the margin of the ASD was clamped with the bilateral occluder, echocardiography was performed again to confirm the tightness of the occluder, making sure that there was no residual shunt and that there was no adverse impact on the structure and function of the superior vena cava, inferior vena cava, the pulmonary veins, coronary sinus orifices, mitral valve, or tricuspid valve. [2–4]


Echocardiographic Evaluation of Changes in Cardiac Hemodynamics and Loading Conditions after Transthoracic Minimally Invasive Device Closure of Atrial Septal Defect.

Chen Q, Sun XD, Cao H, Zhang GC, Chen LW, Hu YN - PLoS ONE (2015)

Final image shown after both discs were deployed.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493115&req=5

pone.0128475.g002: Final image shown after both discs were deployed.
Mentions: The locations, sizes, and margins of atrial septal defects were identified using transthoracic echocardiography prior to the procedure for screening cases for the study. (Fig 1) [5–7] An appropriately sized occluder (which was manufactured at Dong Guan Ke Wei Medical Apparatus Co. Ltd. of China) was selected according to the preoperative echocardiography measurement, and was placed in the delivery sheath after soaking in heparin saline. During the procedure, under the guidance of a parasternal ultrasonographic 4-chamber view, the delivery sheath was placed into the left atrium through the ASD. Then, via the sheath, the occluder inside the left atrium was opened, and it was then pulled back tightly. Thereafter, the occluder inside the right atrium was opened. (Fig 2) After the margin of the ASD was clamped with the bilateral occluder, echocardiography was performed again to confirm the tightness of the occluder, making sure that there was no residual shunt and that there was no adverse impact on the structure and function of the superior vena cava, inferior vena cava, the pulmonary veins, coronary sinus orifices, mitral valve, or tricuspid valve. [2–4]

Bottom Line: One week after the procedure, the right ventricular fractional area change, three-dimensional right ventricular ejection fraction, right ventricular Tei index and tricuspid annular plane systolic excursion had significantly reduced compared with the preoperative data (P<0.05).While these four parameters were still decreased at the 3 months and at 1 year's follow-up, but the differences were not statistically significant compared with the 1 week's postoperative data (P>0.05).One week post-procedure, left ventricular ejection fraction had not changed significantly, but at 3 months and at 1 year post-procedure, left ejection fraction had increased significantly compared with the preoperative data (P<0.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, P. R. China.

ABSTRACT

Purpose: To evaluate transthoracic minimally invasive device closure of atrial septal defects by performing transthoracic echocardiography to measure changes in cardiac hemodynamics and loading conditions.

Methods: Between January 2012 and December 2012, we performed transthoracic minimally invasive device closure of atrial septal defects in 95 patients with secundum atrial septal defects (ASD), and performed transthoracic echocardiography to measure blood flow velocities at the tricuspid valve orifice and at the pulmonary valve orifice, sizes of the left and right atria and ventricles, right ventricular fractional area change, right ventricular Tei index, three-dimensional right ventricular ejection fraction, tricuspid annular plane systolic excursion and left ventricular ejection fractions before the procedure and 1 week, 3 months, and 1 year post-procedure.

Results: Varying degrees of improvement were observed post-procedure at later time points. The maximum blood flow velocity at the pulmonary valve orifice, mean flow velocity, velocity-time integral, and A peak and E peak blood flow velocity at the tricuspid valve orifice decreased significantly post-procedure (P<0.05). In 3 months and 1 year's follow-up, the inner diameter of the middle portion of the pulmonary artery, and diameters of the right atrium and right ventricle decreased significantly post-procedure (P<0.05). The diameters of the left atrium and left ventricle increased after the procedure (P<0.05). One week after the procedure, the right ventricular fractional area change, three-dimensional right ventricular ejection fraction, right ventricular Tei index and tricuspid annular plane systolic excursion had significantly reduced compared with the preoperative data (P<0.05). While these four parameters were still decreased at the 3 months and at 1 year's follow-up, but the differences were not statistically significant compared with the 1 week's postoperative data (P>0.05). One week post-procedure, left ventricular ejection fraction had not changed significantly, but at 3 months and at 1 year post-procedure, left ejection fraction had increased significantly compared with the preoperative data (P<0.05).

Conclusion: Echocardiographic evaluation has demonstrated that cardiac hemodynamics and loading conditions improved significantly after transthoracic minimally invasive device closure of atrial septal defects.

No MeSH data available.


Related in: MedlinePlus