Right ventricular hemodynamics in patients with atrial septal defect

Objective To determine the changes of right heart hemodynamics in patients with secondary ostium secundum type-atrial septal defect (ASD) , including single hole, dual hole, and multihole. Methods A total of 150 patients with secondary ostium secundum type-ASD were examined by transesophageal echocardiography (TEE) to further confirm the defect type. All patients were divided into the single hole group (n=84) , dual hole group (n=45) and multihole group (n=21) according to the number of defects. Under the same conditions, the apical 4-chamber (A4C) and parasternal short axis (PSAX) examinations were performed in each group. The echocardiographic images and haemodynamic parameters, such as right atrium diameter (RAD) , right ventricle diameter (RVD) , right ventricular anterior wall (RVAW) , main pulmonary artery diameter (MPAD) , interventricular septum diameter (IVSD) and pulmonary valve systolic velocity (PVSV) were collected. The brain natriuretic peptide (BNP) in each group was determined. Results In the patients with ostium secundum type-ASD, the single hole group accounted for about 56%, the dual hole group accounted for about 30%, and the multihole group accounted for about 14%. Compared with the single hole group and multihole group, the RAD, RVD and MPVD in the dual hole group were low, whereas the PVSV, RVAW and BNP were high (all P<0.05) . There was no statistically significant difference in the IVSD. Conclusion The single hole defect accounts for the most of secondary ostium secundum type-ASD. The dual hole defect shows more significant effect on right heart hemodynamics and cardiac function. Key words: Congenital heart disease; Atrial septal defect; Hemodynamics