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Mid-Term Outcome of Left Ventricle Reverse Remodeling After Atrial Septal Defect Closure: A Comparison Between Surgical and Device Groups

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Abstract

Right ventricular (RV) volume overload occurs in patients with significant atrial septal defect (ASD II) shunts, which can impair left ventricle (LV) filling, thus decreasing LV indices. However, after ASD II closure, the left ventricle regains near normal dimensions. The purpose of this study was to compare the long-term outcomes of LV reverse remodeling between device and surgical closure. We retrospectively reviewed the echocardiographic data of 222 patients with isolated ASD II who underwent surgical (95 patients) or device closure (127 patients) between January 2012 and December 2017. The ASD II was significantly larger in the surgical closure group (p < 0.001.) leading to a higher degree of paradoxical interventricular septal (IVS) movement. In contrast, the LV volume was larger in the device closure group (p < 0.001). After a median follow-up period of 19.5 months, the maximum LV systolic and diastolic volumes were reached at 1 year in the device closure group and 2 years in the surgical closure group. IVS motion normalized in 91% of the device closure group compared to 57% of the surgical closure group (p =  < 0.001). There was significant improvement in left ventricular indices and IVS motion after ASD II closure in both groups but more favorable in patients after device closure.

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Acknowledgements

We are thankful to our colleagues: M Godman from Edinburgh, Dr. Ahmed Tayeb, Dr. Bassam Al Madi & Dr. Hafez Al Abdulllah for their help. In addition, to our colleagues in Pediatric Cardiology and Pediatrics Cardiac Surgery Departments.

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Authors and Affiliations

  1. Division of Pediatrics, Department of Cardiology, King Salman Armed Forces Hospital, Tabuk, Saudi Arabia

    Muflih Albalawi

  2. Department of Pediatric Cardiology, Prince Sultan Cardiac Center (PSCC), Riyadh, Saudi Arabia

    Salim Ahmad, Mohamed Al Nasef, Abdulmajeed Alotay, Najlaa Al Rajaa, Atif Alsahari & Irfan Saleem

  3. The King Abdul-Aziz Cardiac Center (KACC), King Abdul-Aziz Medical City (KAMC), Riyadh, Saudi Arabia

    Jassim Mohamed Abudlhamed

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  1. Muflih Albalawi
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  2. Salim Ahmad
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Correspondence to Muflih Albalawi.

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The Institutional Research Ethics Committee of Prince Sultan Cardiac Center approved the study protocol (Research file number R19014).

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Albalawi, M., Ahmad, S., Nasef, M.A. et al. Mid-Term Outcome of Left Ventricle Reverse Remodeling After Atrial Septal Defect Closure: A Comparison Between Surgical and Device Groups. Pediatr Cardiol 43, 1530–1538 (2022). https://doi.org/10.1007/s00246-022-02879-z

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  • DOI: https://doi.org/10.1007/s00246-022-02879-z

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