Biventricular Diastolic Functions before and After Interventional Occlusion of Interatrial Communication

Abstract

Background: Interventional closure of an interatrial communication (IAC) can result in early and/or persistent differences in cardiac physiology and structure. We aimed to assess initial consequences of catheter-based closure of IACs on diastolic function of both ventricles. Methods: This prospective study included 68 children. Study participants were divided into patients with IAC and a control group with normal intracardiac anatomy (n = 34 in each group). Transthoracic Echocardiographic evaluation was performed before and one week after IAC occlusion. Results: The peak tricuspid inflow E and A wave velocities, mitral E and A wave maximal inflow velocities, and estimated pulmonary artery systolic blood pressure were 78.12 ± 18.17 , 60.31 ± 19.06, 84.50 ± 14.52, 67.96 ± 21.29 cm/sec and 28.67 ± 5.91 mmHg in the cases compared with 80.14 ± 27.77, 65.38 ± 41.9, 94.73 ± 34.96, 59.47 ± 19.42 cm/sec and 27.94 ± 3.44 mmHg in the control group (all p values > 0.05). left atrial and ventricular areas were smaller in cases compared with control group at baseline. Conclusion: LA and LV areas were smaller in cases compared with healthy children pre-intervention which points to sizable IACs which allow shunting of blood flow away from LA and LV in our patients. A significant reduction in early and late peak tricuspid inflow velocity was observed in our patients after percutaneous IAC occlusion. This reduction in RV inflow velocity may be due to the reduction of RV volume overload after the intervention.