Long Term Follow up of Biatrial Function after Transcatheter Closure of Atrial Septal Defect

Ezzeldin, Dina; Roushdy, Alaa Mahmoud; Khaled, Amr; ElSayegh, Aya Tarek

doi:10.21608/asmj.2025.361418.1395

Long Term Follow up of Biatrial Function after Transcatheter Closure of Atrial Septal Defect

Document Type : Original Article

Authors

¹ Cardiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

² Cardiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

10.21608/asmj.2025.361418.1395

Abstract

Background: Atrial septal defect (ASD) is a prevalent congenital cardiac anomaly with significant long-term complications if untreated, including atrial fibrillation (AF) and pulmonary hypertension. Device closure is a preferred treatment option with well-documented benefits for right ventricular remodelling, but its impact on long-term biatrial function remains underexplored.
Aim of the Work: This study aims to evaluate long-term biatrial function in patients undergoing transcatheter ASD closure.
Methods: This prospective case-control study included 40 patients who underwent transcatheter ASD closure at least three years prior and 40 age- and sex-matched healthy controls. Comprehensive echocardiographic evaluation, including 2D speckle tracking echocardiography (STE), was performed to assess right and left atrial strain (reservoir, conduit, and contractile) and volumetric indices.
Results: Compared to controls, patients demonstrated significantly reduced right atrial (RA) Reservoir Strain (RS) (32.75 ± 9.36% vs. 43.05 ± 12.05%, P < 0.001), Cond S (17.55 ± 7.67% vs. 23.85 ± 5.72%, P < 0.001), and Cont S (13.38 ± 5.87% vs. 16.73 ± 5.20%, P = 0.008). Left atrial (LA) Cont S was also reduced (16.28 ± 4.84% vs. 18.58 ± 5.32%, P = 0.047). Patients who underwent closure before age 15 had better biatrial function, with strain values approximating those of controls (e.g., RA RS: 38.35 ± 7.98% vs. 43.05 ± 12.05%, P = 0.032).
Conclusions: Early ASD closure (<15 years) preserves atrial function, with near-normal strain values, while later closure is associated with significant long-term impairment, particularly in RA.

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