Atrial Septal Defect (ASD), can be found up to 30% among adults with Congenital Heart Disease. Generates a progressive chronic volume overload of the Right Ventricle (RV), specially in large defects. Over time dilates the Tricuspid Annullus, generates ventricular disfunction, heart failure, arrhythmias and intracavitary thrombosis, more evident after the fourth decade of life. Pulmonary Artery Hipertension generates chronic RV pressure overload. We believe that many patients with indication of ASD closure also need Tricuspid repair with annuloplasty (TA).
Methods: Prospective and longitudinal study with mid-term follow up. From August 2006 - October 2008, we performed 18 ASD closures with TA using MC3 Edwards or Duran Rings, with Transesophageal Ecocardiographic during surgery (TTEE), clinical and transthoracic echocardiogram follow-up (FU).
Results: mean age at surgery: 39,38 years (range 23-56), more frequent in females: 16 cases (88%). ASD types: Ostium Secundum 8 cases (44%), Sinus Venosus 6 cases (34%), Ostium Primum 2 cases (11%), residual post surgical 2 cases (11%). Preoperative TR: severe (9 cases, 50%), moderate (9 cases, 50%). In all cases, we performed ASD closure with bovine pericardial patch. Durán Ring, 5 cases (27-33 mm); MC3 Ring 13 cases (28-34 mm). TTEE revealed TR improvement in all cases. Short and mid-term follow up TR: none, 6 cases; trivial, 3 cases; mild 7 cases, moderate in 2 cases.
Conclusions: In patient that fill criteria por ASD closure and TR, we consider useful TA. It improves post-surgical recovery. During mid-term follow-up improves ventricular performance.