Clinical Study Of The Changes In Cardiac Morphology And Function After Transcatheter Closure Of Atrial Septai Defect In Adults

Objective The purpose of this study was to evaluate the changes in cardiacmorphology and function after transcatheter closure of atrial septai defect(ASD) inadults; to explore the impact factors of postoperative incomplete right heart reverseremodeling in adults with ASD.Methods Data of all adult ASD admissions, aged eighteen years and over, inthe people’s hospital of GuangXi Zhuang autonomous region hospital between June2008and April2013were obtained before and after a time of more than30daysfrom the correction．The data included their baseline clinical features, chest plainradiographs, electrocardiogram, echocardiography. The data was compared in24to48hours before/after ranscatheter closure, and so as to the1stmonth,3rdmonth and6thmonth follow-up．To determine the factors for iRVR by The chi-square test andT test of single factor and multiple factors unconditonal logistis regression analysis.Results (1) The obvious deflation and normal size recovery of right atriumand ventriculum were observed in48hours after transcatheter closure The systolicpressure of pulmonaryartery was reduced significantly in48hours after thetherapy．The left ventricular end-systolic dimension (LVDd) was enlarged in1month after the therapy, and theleft atrial diameter was enlarged in3rdmonth afterthe therapy. However, LVEF showed no apparent change. RBBB was observed in30patients preoperatively．Four diminished1month and five diminished3month after occlusion (2)Single factor analysis demonstrate the age, pulmonary arterypressure(PAH), RBBB, RADtr, RVDd and the diameter of ASD which all hadstatistical significance (P<0.05separately). Multiple factors regression analysisdemonstrate that there was the correlation between PAH, the diameter of ASD andage, which all had statistical significance (P<0.05separately). Importantly,OR(11.604) of PAH was the highest.Conclusions The transcatheter closure of the secondary ASD reduced thevolume load of right heart, which led to obvious trial and ventricular deflationshortly after occlusion, PAH, the diameter of ASD and age, with ASD patients inadults all can be predictive factor for iRVR.