Incidence and predictors of atrial septal defect after percutaneous transvenous mitral commissurotomy - a transesophageal echocardiographic study of 209 cases
| Autor: | Arunkumar Panneerselvam, K. H. Srinivasa, Bhat Prabhavathi, Chandrasekaran Dhanalakshmi, K.S. Ravindranath, Kapil Rangan, C.N. Manjunath |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Cardiac Catheterization Catheterization Central Venous Adolescent India Regurgitation (circulation) Heart Septal Defects Atrial Young Adult Postoperative Complications Mitral valve Internal medicine medicine Humans Mitral Valve Stenosis Radiology Nuclear Medicine and imaging Fossa ovalis cardiovascular diseases Cardiac Surgical Procedures Retrospective Studies Heart septal defect business.industry Incidence Retrospective cohort study Middle Aged medicine.disease Echocardiography Doppler Surgery Shunting Stenosis medicine.anatomical_structure cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Echocardiography Transesophageal Interatrial septum Follow-Up Studies |
| Zdroj: | Echocardiography (Mount Kisco, N.Y.). 30(2) |
| ISSN: | 1540-8175 |
| Popis: | Background The incidence of atrial septal defect (ASD) after percutaneous transvenous mitral commissurotomy (PTMC) ranges from 15.2% to 92% in small studies. Aim To estimate the incidence of atrial septal defect (ASD) following PTMC and to determine the factors contributing to its development. Methods We studied 209 patients with mitral stenosis (MS) undergoing PTMC. Transesophageal echocardiography (TEE) with color Doppler examination was performed to detect ASD. Results TEE demonstrated ASD in 139 (66.5%) of 209 patients. The mean diameter of the interatrial septal defect detected by TEE was 4.47 ± 1.7 mm. The most common site of septal puncture was the inferior vena caval side of the interatrial septum followed by fossa ovalis. Color flow imaging across the defect showed left to right shunting in all the patients (100%). We examined the relationship of age, Wilkins score, left atrial volumes, the mitral valve orifice area, mitral valve gradient, and the degree of mitral and tricuspid regurgitation between the group that developed ASD and the group without ASD and found that none of these factors predicted the development of ASD. A residual ASD was seen in 11 patients (8.7%) at 6-month follow-up. Conclusion Incidence of residual atrial septal defect immediately following PTMC by TEE color flow Doppler imaging is 66.5%. Surrogate markers of elevated left atrial pressures do not determine the development of atrial septal defect after PTMC. The majority of the defects close spontaneously and a residual defect is observed in 8.7% patients at 6 months. |
| Databáze: | OpenAIRE |
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