Closure of atrial septal defect in the adult. Cardiac remodeling is an early event

Int J Cardiol. 2006 Apr 14;108(3):370-5. doi: 10.1016/j.ijcard.2005.05.042. Epub 2005 Jun 27.


Background: Study aimed to describe the extent and the temporal profile of cardiac remodeling after atrial septal defect closure in the adult.

Methods: Prospective and longitudinal echocardiographic assessment of right and left heart size before and after (1 day-1 week/1/4/12 months) surgical or catheter-based atrial septal closure in 39 adults (age 54+/-15 years).

Results: Right ventricular and atrial sizes were markedly reduced, left ventricular size increased and left atrial size remained unchanged after closure. Older age and a history of atrial fibrillation reduced the potential to normalize right and left atrial size after closure. The greater part of the changes occurred very early, in the 1st day/1st week. From then on the speed of change gradually diminished and after 4 months no important changes were observed. The mode of closure did not influence the degree or the pace of the remodeling.

Conclusion: Cardiac remodeling after atrial septal closure in the adult is a common and early event that seems by and large completed within the first half year after closure. The ventricles seem to have a higher capacity of remodeling than the atria in this setting. The mode of closure does not seem to significantly impact remodeling.

MeSH terms

  • Adult
  • Aged
  • Atrial Function, Right
  • Female
  • Heart Atria / pathology
  • Heart Septal Defects, Atrial / pathology
  • Heart Septal Defects, Atrial / physiopathology
  • Heart Septal Defects, Atrial / surgery*
  • Heart Ventricles / pathology
  • Humans
  • Male
  • Middle Aged
  • Postoperative Period
  • Ventricular Function, Left
  • Ventricular Remodeling*