Objective: The impact of transcatheter closure of ASD by Amplatzer septal occluder (ASO) on LV wall motion remains uncertain. We investigate to evaluate the changes of LV wall motion before and after ASO.
Methods: 19 patients with ASD who underwent ASO (ASO-Gr, aged 13.2±6.9 years) included in this study. 2D images of short axis and apical four-chamber view were obtained by Vivid 7 with S3 probe (GE) at before, 1day, 1, 3, 6 and 12 months after ASO, respectively. The acquired images were analyzed by EchoPAC (GE) to calculate radial (SR), circumferential (SC) and longitudinal (SL) strain, radial (DR) and longitudinal (DL) displacement and LV Torsion. LV was divided into 6 segments to evaluate the regional wall motion. These data was compared to those of 6 normal children (N-Gr, aged 5.5±0.5 years).
Results: (1) The preoperative DR of anterior-septal and septal segments of ASO-Gr was significantly lower than those of N-Gr: mid anterior-septal(3.6±1.5 vs. 4.7±0.8mm/m), mid septal (2.5±0.9 vs. 4.0±0.8mm/m). (2) There was no significant difference between ASO-Gr and N-Gr in SR, SC, SL, DL, LV Torsion. (3) There was no significant change in SR, SC, SL, LV Torsion before and after ASO until 12 months, however, DR of anterior-septal and septal segments were significantly increased (mid anterior-septal; 2.5±1.0→3.7±0.7mm/m, p<0.001).
Conclusions: Strain and torsion of LV in ASD patients were preserved before and after ASO. Displacement of LV septum was reduced and recovered by ASO as improving RV volume overload, which associates with the improvement of paradoxical septal wall motion.