Echocardiographic Evaluation of Right Heart and Hemodynamic Changes After Transcatheter Secundum Atrial Septal Defect Closure in Adults: A Single-Center Retrospective Study
Bibliographic record
Abstract
Background: Transcatheter closure of secundum atrial septal defects (ASDs) is a widely accepted intervention in adults with left-to-right shunting and right heart volume overload. However, the time course and magnitude of cardiac remodeling and functional improvement after closure remain incompletely defined. This study evaluated serial echocardiographic changes in right heart structure and hemodynamics following ASD closure. Methods: In this single-center retrospective cohort, adults who underwent transcatheter secundum ASD closure between January 2020 and December 2023 were included. Echocardiography was performed at baseline, immediately post-procedure, at 3 to 6 months, and at 1 year. Parameters included right atrial (RA) area and volume index (RAVI), right ventricular (RV) dimensions, pulmonary valve velocities, RV systolic pressure (RVSP), mean pulmonary artery pressure (mPAP), tricuspid annular plane systolic excursion (TAPSE), and tricuspid regurgitation (TR) severity. Analyses used Wilcoxon signed-rank tests, Chi-square tests, repeated-measures analysis of variance (ANOVA)/multivariate ANOVA (MANOVA), and mixed-effects models. Results: Eighty patients were included (mean age: 42.3 ± 15.0 years; 72.5% female). Immediately after closure, significant reductions were observed in TR Vmax (-20.8 cm/s, P = 0.0005), pulmonary valve Vmax (-32.1 cm/s, P < 0.0001), Vmean (-18.6 cm/s, P < 0.0001), velocity time integral (VTI) (-6.9 cm, P < 0.0001), RA area (-2.6 cm2, P < 0.0001), RAVI (-7.0 mL/m2, P < 0.0001), RVSP (-7.7 mm Hg, P < 0.0001), QP:QS (-0.8, P ≤ 0.0001), and mPAP (-10.0 mm Hg, P = 0.0007). Improvements were sustained at 3 - 6 months (n = 54) and at 1 year (n = 19). Conclusions: Transcatheter ASD closure in adults results in early and sustained improvements in RA and ventricular remodeling, pulmonary pressures, and TR severity. These findings underscore the role of echocardiography in longitudinal surveillance and support timely intervention in patients with significant shunting (QP:QS > 1.5). Larger multicenter studies with extended follow-up and correlation to clinical outcomes are warranted.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".