Twenty-one consecutive patients had a surgical closure for ASD (09 sinus venosus and 12 defect with rim deficiency).We define two groups, group 1 formed with patients aged under 12 years at the moment of the surgery and group 2 with patients aged over 12 years old. The patients were assessed with echocardiography, before the procedure and at 1, 2 and 5 years.
The mean ASD size was 26±7.4mm. The difference between the two groups at one year was significant, four-chamber right ventricular (RV) size (21 vs. 25mm/m2), paradoxical septal motion (38% vs. 50%), right atrial length(24 vs. 27mm/m2), RV fractional area change (RVFAC) (38% vs. 34%), tricuspid lateral annular systolic velocity (S’) (11 vs. 9cm/s), RV dP/dt (530 vs. 380), isovolumic velocity and isovolumic acceleration[IVA] (3.4 vs. 2.2 m/s2), and echocardiographically determined pulmonary artery systolic pressure decreased significantly and was maintained at 5 years follow-up only in group 1. At 5 years, 39% of patients had persistent RV enlargement in group 2.
Right heart morphology undergoes rapid improvement within one year of defect closure in young patients (<12 years) while patients aged over 12 years had less improvement and persistent RV enlargement or pulmonary hypertension, or both, at five year.