Heart remodeling following transcatheter closure of ostium secundum type of interatrial communication.

Introduction The ostium secundum type of Interatrial communication is a condition that requires early closure of this defect because of its anatomicaland hemodynamic impact on the right ventricle and the pulmonary arterial bed. The correction of Atrial Septal Defect brings along with it,the reduction in right cavities’ volumetric overload and this produces better heart remodeling with beneficial electrical and mechanical effects.Objective To evaluate the geometric heart changes in patients who undergo transcatheter closure of interatrial communication with the AmplatzerSeptal Occluder.Method A prospective, descriptive study was carried out on 110 individuals with foramen ovale type of interatrial communication who underwenttranscatheter correction at the William Soler pediatric heart center, from May 2003 through April 2010. These individuals were assessedwith echocardiography, chest radiography, and electrocardiography before the procedure and these were repeated at 3, 6 and 12months after it was carried out.Results We found a reduction of the cardio-thoracic ratio from 54±7 to 50±4 (p<0.001), while the electrocardiographic analyses revealed P-Rinterval reduction (184±6 to 129±4, p<0.001), reduction of the QRS complex duration (123±4 to 93±2, p<0.001) and of its frontalelectrical axis (70±280 to 58±170, p<0.001). The echocardiographic evaluation showed a reduction of the right ventricular (43±10 to33±4, p<0.001) and right atrial (45±6 to 35±4, p<0.001) diameters as well as an increase in left ventricle ejection fraction (64% to68%).Conclusions The transcatheter correction of the atrial septal defects produces changes in the heart geometry even though increased defect closureage related diameters may persist.