Short-Term Cardiac Functional Change Following Transcatheter Atrial Septal Defect Closure: A Prospective Echocardiographic Study.

BACKGROUND: Atrial septal defect (ASD) is a common congenital heart anomaly causing a significant hemodynamic burden if untreated. Transcatheter closure is a minimally invasive standard treatment, but prospective data on short-term cardiac remodeling are limited.

AIMS: To evaluate short-term echocardiographic changes in cardiac structure and function following transcatheter ASD closure in adults.

METHODS: This prospective observational cohort study included 112 patients aged 15-68 years who underwent transcatheter ASD closure. Comprehensive echocardiography was performed pre-procedure and at 1 and 6 months postprocedure. Parameters assessed included right and left ventricular dimensions, atrial volumes, right ventricular systolic pressure (RVSP), pulmonary artery pressure (PAP), tricuspid regurgitation (TR) severity, and right ventricular ejection fraction (RVEF).

RESULTS: Significant reductions in right atrial volume index (RAVI) by 4.5 ± 5.19 mL/m², right ventricular internal diameter, RVSP by 6.8 ± 9.44 mmHg, PAP decreased by 6.46  ±  8.50 mmHg, and TR severity were observed at 6 months (all p < 0.05). Left ventricular dimensions and ejection fraction remained stable, indicating preserved left-heart function. RVEF improved in 31% of patients by 6 months. Cardiac rhythm remained unchanged. Notably, reverse remodeling magnitude and timing were independent of baseline ASD size.

CONCLUSION: Transcatheter ASD closure results in early and sustained right-heart reverse remodeling and pulmonary pressure reduction, without adverse effects on left ventricular function or cardiac rhythm. These consistent benefits, regardless of defect size, support the safety and efficacy of this minimally invasive intervention.