Comparison of acute effects on right ventricular haemodynamics of surgicalversus interventional closure of atrial septal defects

Objectives: We compared the acute effects on right ventricular haemodynamic s of surgical versus transcatheter closure of medium-sized atrial septal de fects. Method's: We studied 47 consecutive patients with a defect in the ov al fossa and a ratio of pulmonary to systemic flows between 1.5: 1 and 2: 1 . They were divided into two groups according to whether the defects were c losed by surgery, performed in 23 patients, or by interventional catheteriz ation, achieved in 24 patients. By means of transthoracic cross-sectional e chocardiography, we measured right ventricular end-diastolic and endsystoli c volumes and calculated ejection fractions. These calculations were perfor med before, and between 1 and 7 days after closure of the defect. Results: Before closure of the defect, all patients had an enlarged right ventricle with normal function. After closure by either method, there was no differen ce in the rate of normalization of end-diastolic volume, but endsystolic vo lume remained enlarged. Thus, the calculated ejection fraction was lower th an before closure. Conclusions: There was no difference in right ventricula r volumes or function early after closure of atrial septal defects, irrespe ctive of whether this was achieved surgically or via transcatheter closure.