The changes of pulmonary function test parameters in children who undergoing transcatheter asd closure

THE CHANGES OF PULMONARY FUNCTION TEST PARAMETERS IN CHILDREN WHO UNDERGOING TRANSCATHETER ASD CLOSURE AIM: This study was performed to assess changes in pulmonary function test (PFT) and pulmonary outcome before and after transcatheter closure of atrial septal defect (ASD) in pediatric patient and compared with healthy children MATERIALS AND METHODS : A total of 17 pediatric patients with age of range 5 and 18 years undergoing transcatheter ASD closure received PFT at baseline (day before ASD closure), and 3 months after procedure. As a control group of 20 healthy children were included. PFT values of both groups were compared. RESULTS: In patients with a mean age of 10.95 ± 2.81 to 9.47 ± 3.59 in the control group were determined. The eleven patients who have atrial septal defect were female (64.7%) and six patients were male (35.3%). The gender of 11 healthy children were (55%) females and 9 (45%) were male. When asked about the complaints of patients two (11.7%) patients with dyspnea, 3 (17.6%) in the exercise intolerance, 12 (70.5%) of them complained of fatigue was present. None of the patients had cough. On physical examination in 13 patients (76%) who had ranging 2/6 - 3/6 systolic murmur which heard better on pulmonary focus was present. In these patients, S2 hard couple were heard. There was no significant murmur in 4 patients (24%).The echocardiographic evaluation of patients with ASDs; on four spaces screen the average diameter was 12.76 ± 5 mm, on bicaval screen the average diameter was 12.35 ± 6.1 mm, mean aortic diameter was measured as 10.82 ± 4.69 mm. The devices used to close the defect average diameter was 16.29 ± 6.41 mm. Forced vital capacity (FVC), forced expired volume in 1 sec (FEV(1)), FEV(1) to FVC ratio (FEV(1)/FVC), peak expiratory flow (PEF), and mean forced expiratory flow during the middle half of FVC (FEF(25-75)) were measured. At baseline, ASD patients had significantly reduced FVC and FEV(1) (p<0,05). FEV1/FVC, PEF and MEF 25-75 also decrease in value, although this decrease was not statistically significant (p>0,05). Three months after transcatheter closure of ASD, FVC, FEV1 and MEF 25-75 showed a statistically significant increase in the values (p<0,05). FEV1/FVC and PEF values had increased, but this increase was not statistically significant (p> 0.05). CONCLUSION: In this study of patients with ASD , FVC and FEV1 values were significantly lower than healthy children. These patients performed 3 months after control of transcatheter closure of ASD, PFTs were evaluated; All of the patients showed an improvement in PFT values. Also, FVC, FEV1 and MEF 25-75 showed a statistically significant increase in value. PFT disturbance was observed in significant flow limitation in the peripheral airway of ASD patients. Improved PFT was found after transcatheter closure and better pulmonary outcome was observed. The assessment of the respiratory tract of ASD patients with SFT was concluded to be helpful.