The clinical electrocardiographic and echocardiographic impacts of secundum type atrial septal defect in adult patients with synus rhytm after the percutaneous transcatheter closure

Objective: It was planned to research the clinical ,electrical and echocardiographic effects early after the percutaneous transcatheter closure of secundum-type ASD in adult patients with sinus rhythm..Methods and Materials:The clinical,electrocardiographic and echocardiographic parameters were evaluated in 27 patients,who had percutaneous transcatheter closure procedure,before and 6 months after the procedure and compared with a control group of 27 healthy volunteers. All patients were clinically compared by the NYHA functional class.P wave dispersion,the QT and QTc dispersions on ECG were compared in patients.In all patients RV, RA and SPAP?s compared by echocardiograph before and after the procedure. Correlation analysis of these parameters wasmade. The obtained values are compared in healthy control group before and after the procedureand by comparing these values the effects of the procedure are researched.Results: ECG findings of patients,before and after ASD closure, are analyzed and P dispersion (59.0 ± 9.9, 45.2 ± 16.3 P < 0.001) showed a statistically significant decrease. Minimum and maximum P wave periods after the closure was in a statistically significant reduction. The same situation was not observed in QT dispersion (38.8 ± 12.3, 33.10 ± 16.9 P = 0.184) and QTc dispersion (44, 8 ± 14.2, 37.3 ± 16.5, p = 0.115) , The correlation analysis was performed on the significant difference in P dispersion before and after percutaneous transcatheter closure procedure, RV diameters and the diameters of the RA. Accordingly, the decrease in RV (0.54, P = 0.04) and RA (0.45, P = 0.03) diameter after closure showed a positive correlation with the reduction in pulmonary artery pressure. Exercise capacities were compared beore and after the percutaneus closure in order to assess the clinical improvement. A statistically significant improvement of the patients were observed in NYHA functional classification.%85.2 patients were found to be NYHA class 2 before treatment and after treatment this rate dropped to 63%. This difference is statistically significant(p = 0.031).When the improved parameters compared with control group before and after the closure , the differences between ASD patients and control group was observed to continue and declined after procedure.Conclusion: Percutaneous transcatheter closure resulted in a significant improvement in P dispersion, SPAP, RV and RA and exercise capacity. QT interval, QTc dispersion did not differ significantly.A positive correlation was observed between the improvement in SPAP and improvement in the RV and the RA diameters.