Detection Of Right Atrium Function Of Preoperative And Postoperative In Patients With Asd By Real Time Three-Dimensional Echocardiography

Objective: To explore the clinical evaluation of right atrium(RA)function in patients with atrial septal defect（ASD） before and after surgery byreal time three-dimensional echocardiography (RT-3DE).Methods: Thirty healthy volunteers and fifty four patients with ASDwere examined by RT-3DE. RA volume indices including: maximum, minimum,pre-atrium contraction RA volume (RAVmax, RAVmin, RAVpre) and RA functionindices including total atrium, passive atrium, active atrium stroke volume(TASV, PASV, AASV) and total, passive, active atrium ejection fraction(RAEF, RAEFpassive, RAEFactive) were measured and calculated by RT-3DE. Useconventional echocardiography to examine the diameter of right atrium(RA),right ventricular(RV) and the main pulmonary artery(MPA), also the systolicpressure of pulmonary artery, end-diastolic and end-systolic diameter of leftventricular(LVd,LVs), stroke volume and ejection fraction of leftventricular(LVSV, LVEF). We compare the results among normal group,pre-surgery group with ASD and post-operative group with ASD. Result: RAVmax, RAVmin, RAVpre, TASV, RAEFactive, RA,RV andMPA were greater in patients with ASD than those of the controls, but RAEFand RAEFpassivewere decreased significantly (P<0.05). The result suggest thatreservoir and pump function of RA enhanced and conduit function reduced, thediameter of right atrium right ventricular and main pulmonary artery widenedin patients with ASD. RAVmax, RAVmin, RAVpre, TASV, RAEFactive, RA, RVand MPA were decreased significantly (P<0.05) in the after2~3days than thoseof the preoperative (P<0.05), but RAEFpassivewere significantly greater(P<0.05).Compared with those of the controls, RAVmax, RAVmin, RAVpre,TASV, RAEFactiveRA,RV, MPA, RAEF and RAEFpassivehad no difference inthe after three months (P>0.05). After ASD surgery, the reservoir, pumpfunction and conduit function of RA turned to be normal level. The diameter ofright atrium, right ventricular and the main pulmonary artery narrowed, thesystolic pressure of pulmonary artery decreased, the diameter of left ventricularwidend, the ejection fraction of left ventricular increased, cardiac remodelingcontinued downturn in the follow-up period, which significantly improvedhemodynamics. The right atrial size of RA and ventricular function in mostpatients with ASD returned to normal levels three months after surgery.Conclusion: ASD heart surgery correct anatomical abnormalities andhemodynamic abnormalities. RT-3DE can detect the hemodynamical changes ofright atrium of preoperative and postoperative with ASD easily, reflect thefunction changes among those groups and provide a reliable reference ofseverity and prognosis and recovery of postoperative with ASD for clinicalevaluation.