Surgical vs. percutaneous atrial septal defect closure: Remote effects on left ventricular diastolic function

While surgical closure used to be the only treatment for atrial septal defects (ASD), recently, placement of an occluding device has become the treatment of choice for this condition. We sought to study the remote effects of surgical vs. device ASD closure on the indices of left ventricular diastolic function. Forty patients – 16 after device and 19 after surgical closure – were evaluated at least 1 year after the procedure. Mitral inflow and tissue Doppler indices were studied. The results were compared to those of 65 control subjects. The early mitral inflow velocities E were higher in controls and E/A ratios were different among all 3 groups. Late diastolic A′ TDI velocities were higher in both device and surgical group patients and more different from the controls in surgical than in device group. It appears that surgical ASD closure alters left ventricular diastolic indices more significantly than device ASD closure.