Atrial septal defect closure prompts speedy cardiac remodeling

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NEW YORK (Reuters Health), May 4 - Closure of an atrial septal defect (ASD) in adulthood is rapidly followed by normalization of the size of the heart chambers. Remodeling is visible within the first day after closure, Swedish researchers report.

In a study published in the April 14th issue of the International Heart Journal, Drs. U. Thielen and S. Persson of Lund University note that they conducted a prospective and longitudinal echocardiographic assessment of the size of the atria and ventricles before and after closure of ASD in 39 adults.

Echocardiography was performed before surgery and at one day, one week, and repeatedly for up to 12 months after catheter-based or surgical closure.

Right ventricle and right atria size decreased markedly and the left ventricle markedly increased in size after closure. The size of the left atrium remained unchanged, the investigators report. Atrial size and pulmonary arterial pressure normalized in most patients. Ventricular function was not assessed.

The bulk of the remodeling occurred within the first week after ASD closure, with changes visible within 24 hours of repair. Remodeling was virtually complete within six months. Mode of closure did not affect the extent or speed of remodeling.

The team concludes that "it seems that the ventricles more readily adapt to the altered hemodynamics than the atria do." The process of remodeling, they add, "is apparently not affected by the mode of closure."

Last Updated: 2006-05-04 10:53:07 -0400 (Reuters Health)

Intl J Cardiol 2006;108:370-375.

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