Rapid Left Ventricular Recovery After Correction of a Secundum Atrial Septal Defect: Understanding the Hemodynamics

Akanksha N. Thakkar; Mahwash Kassi; C. Huie Lin

doi:10.14797/mdcj-13-3-160

Rapid Left Ventricular Recovery After Correction of a Secundum Atrial Septal Defect: Understanding the Hemodynamics

Methodist DeBakey Cardiovascular Journal

Volume 13 (2017): Issue 3

By: Akanksha N. Thakkar, Mahwash Kassi and C. Huie Lin

Open Access

|Jul 2017

Abstract

Closure of an atrial septal defect (ASD) may lead to a change in the function of both ventricles. Although right ventricular function typically improves, the left ventricle (LV) may behave in different ways. This has been a matter of much debate, with some authors reporting a decline in LV function after ASD closure and others reporting delayed improvement or no identifiable change. We report the case of a 41-year-old female with a large left-to-right ASD shunt (Qp:Qs 2.3:1 and shunt volume 3.6 L/min) who presented with biventricular systolic dysfunction that improved within 24 hours of ASD closure. We also attempt to explain the underlying hemodynamics responsible for LV failure and recovery in this patient.

References

van der Linde D , Konings EE , Slager MA , Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol. 2011 Nov 25; 58 21: 2241– 7.
Search in Google Scholar Back to article
Tikoff G , Schmidt AM , Kuida H , Hecht HH. Heart failure in atrial septal defect. Am J Med. 1965 Oct; 39 4: 533– 51.
Search in Google Scholar Back to article
Bonow RO , Borer JS , Rosing DR , Bacharach SL , Green MV , Kent KM. Left ventricular functional reserve in adult patients with atrial septal defect: pre- and postoperative studies. Circulation. 1981; 63: 1315– 22.
Search in Google Scholar Back to article
Popio KA , Gorlin R , Teichholz LE , Cohn PF , Bechtel D , Herman MV. Abnormalities of left ventricular function and geometry in adults with an atrial septal defect. Am J Cardiol. 1975; 36: 302– 8.
Search in Google Scholar Back to article
Booth DC , Wisenbaugh T , Smith M , DeMaria AN. Left ventricular distensibility and passive elastic stiffness in atrial septal defect. J Am Coll Cardiol. 1988 Nov; 12 5: 1231– 6.
Search in Google Scholar Back to article
Masutani S Senzaki H. Left ventricular function in adult patients with atrial septal defect: implication for development of heart failure after transcatheter closure. J Card Fail. 2011 Nov; 17 11: 957– 63.
Search in Google Scholar Back to article
Teo KS , Dundon BK , Molaee P , Percutaneous closure of atrial septal defects leads to normalisation of atrial and ventricular volumes. J Cardiovasc Magn Reson. 2008 Dec 1; 10 55.
Search in Google Scholar Back to article
Vijayvergiya R , Singh J , Rana SS , Shetty R , Mittal BR. Early and six-month assessment of bi-ventricular functions following surgical closure of atrial septal defect. Indian Heart J. 2014 Nov–Dec; 66 6: 617– 21.
Search in Google Scholar Back to article
Santoro G , Pascotto M , Sarubbi B , Early electrical and geometric changes after percutaneous closure of large atrial septal defect. Am J Cardiol. 2004; 93: 876– 80.
Search in Google Scholar Back to article
Weber M , Dill T , Deetjen A , Left ventricular adaptation after atrial septal defect closure assessed by increased concentrations of N-terminal pro-brain natriuretic peptide and cardiac magnetic resonance imaging in adult patients. Heart. 2006 May; 92 5: 671– 5.
Search in Google Scholar Back to article
Chen Q , Sun XD , Cao H , Zhang GC , Chen LW , Hu YN. Echocardiographic evaluation of changes in cardiac hemodynamics and loading conditions after transthoracic minimally invasive device closure of atrial septal defect. PLoS One. 2015 Jul 6; 10 7: e0128475.
Search in Google Scholar Back to article
Bussadori C , Oliveira P , Arcidiacono C , Right and left ventricular strain and strain rate in young adults before and after percutaneous atrial septal defect closure. Echocardiography. 2011 Aug; 28 7: 730– 7.
Search in Google Scholar Back to article
Carabello BA , Gash A , Mayers D , Spann JF. Normal left ventricular systolic function in adults with atrial septal defect and left heart failure. Am J Cardiol. 1982 Jun; 49 8: 1868– 73.
Search in Google Scholar Back to article
Wu ET , Akagi T , Taniguchi M , Differences in right and left ventricular remodeling after transcatheter closure of atrial septal defect among adults. Catheter Cardiovasc Interv. 2007; 69: 866– 71.
Search in Google Scholar Back to article
Ewert P , Berger F , Nagdyman N , Kretschmar O , Lange PE. Acute left heart failure after interventional occlusion of an atrial septal defect. Z Kardiol. 2001 May; 90 5: 362– 6.
Search in Google Scholar Back to article

Articles in this issue

DOI: https://doi.org/10.14797/mdcj-13-3-160 | Journal eISSN: 1947-6108

Journal RSS Feed

Language: English

Page range: 160 - 164

Published on: Jul 1, 2017

Published by: Houston Methodist DeBakey Heart & Vascular Center

In partnership with: Paradigm Publishing Services

Keywords:

atrial septal defect,

left ventricular dysfunction

© 2017 Akanksha N. Thakkar, Mahwash Kassi, C. Huie Lin, published by Houston Methodist DeBakey Heart & Vascular Center
This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 License.

Volume 13 (2017): Issue 3