Right to left shunt through interatrial septal defects in patients with congenital heart disease: results of interventional closure. Issue 6 (3rd November 2005)

• Record Type: Journal Article
• Authors: Agnoletti, G; Boudjemline, Y; Ou, P; Bonnet, D; Sidi, D
• Is Part Of: Heart. Volume 92:Issue 6(2006)
• Page Start: 827
• Page End: 831
• Publication Date: 2005-11-03
• Subjects: ASD, atrial septal defect -- CHD, congenital heart disease -- METs, metabolic equivalents -- PFO, persistent foramen ovale; cardiac catheterisation -- atrial septal defect -- persistent foramen ovale -- cyanosis; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2005.071092
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objective: To study the effects of closure of interatrial communications associated with a right to left shunt in patients with congenital heart disease (CHD) who had a biventricular repair. Design: Retrospective study. Setting: Tertiary referral centre. Patients: 15 patients with CHD with right to left shunt through an interatrial communication: three had repaired tetralogy of Fallot, five had repaired pulmonary atresia with intact ventricular septum, four had Ebstein's disease, and three had other CHDs. Two patients had had a stroke before closure of the interatrial communication. Interventions: Percutaneous atrial septal defect (n = 6) or persistent foramen ovale (n = 9) closure. All patients underwent an exercise test before and after interatrial communication closure. Results: Five patients were cyanotic at rest. During exercise, mean (SD) oxygen saturation diminished from 93.9 (3.8)% to 84.3 (4.8)% (p < 0.05). Interatrial communication closure led to an immediate increase of oxygen saturation from 93.9 (3.8)% to 98.6 (1.6)% (p < 0.05). At a median follow up of three years (range 0.5–5) all but one patient with a residual atrial septal defect had normal oxygen saturation at rest and during exercise. Maximum workload increased from 7.2 (1.9) to 9.0 (2.2) metabolic equivalents (p < 0.001). Conclusions: Percutaneous closure of interatrial communications associated with a right to left shunt allows restoration of normal oxygen saturation at rest, avoidance of desaturation during exercise, and improvement of exercise performance in patients with CHD.