Real-time Three-dimensional Echocardiography In Assessing Effect Of Atrial Septal Defect Occlusion On Left Heart Volume And Mitral Annular Motion

Objective:To evaluate the effect of atrial septal defect occlusion on left ventricular structure and motion of the mitral annulus using real-time three-dimensional echocardiography. Methods:Thirty-seven patients receiving atrial septal defect occlusion underwent real-time three-dimensional echocardiography one day before, one and three months after operation. Left ventricular end diastolic volume, left ventricular end systolic volume, left atrial end diastolic volume, left atrial end systolic volume, left ventricular ejection fraction, and mitral annular displacement were measured and compared between pre-and post-operation and the change rate of Left ventricular end diastolic volume, left ventricular end systolic volume, left atrial end diastolic volume, left atrial end systolic volume, three months after operation were calculated. The correlations between volume change rate of left heart and the occlude size, the endocardial cushion stump and mitral annular displacement were analyzed. Results:One and three months after operation, Left ventricular end diastolic volume, left ventricular end systolic volume, left atrial end diastolic volume, left atrial end systolic volume were all increased compared with preoperation, and there were also significant differences between one and three months after operation (all P<0.05). There were no significant changes in left ventricular ejection fraction and mitral annular displacement at three different time points. The occlude size was positively correlated with change rate of left ventricular end diastolic volume, left ventricular end systolic volume, left atrial end diastolic volume, left atrial end systolic volume, respectively (r=0.91,0.79,0.82,0.83, P<0.05) and the endocardial cushion stump was no correlated with mitral annular displacement (r= 8.16,P> 0.05). Conclusions:In atrial septal defect patients, the left heart volume significantly increased after occlusion compared with preoperation, while there was no correlation between endocardial cushion stump and mitral annular displacement, which can be effectively detected by real-time three-dimensional echocardiography.