Circulation, Vol 61, 888-896, Copyright © 1980 by American Heart Association
TL Schreiber, H Feigenbaum and AE Weyman
To ascertain the effects of surgical closure of atrial septal defect on
left ventricular geometry and degree of mitral prolapse, 14 patients with
atrial septal defect were studied by cross-sectional and M-mode
echocardiography preoperatively and 7 days postoperatively. Seven of the 14
patients (50%) had mitral valve prolapse preoperatively by cross- sectional
echocardiography. To quantitate the degree of prolapse, we measured the net
algebraic area subtended by the apposed mitral valve leaflets in systole
(MVAS) with respect to the mitral ring. The mitral valve prolapse group had
an MVAS of 0.3 +/- 3.1 units (mean +/- SEM) preoperatively, while the group
without mitral valve prolapse had an MVAS of 12.5 +/- 3.1 units (p less
than 0.02). Postoperatively, prolapse either decreased in degree or was
abolished in six of seven patients (86%), associated with an increase in
MVAS to 14.7 +/- 4.4 units (p less than 0.02). In all patients, septal
curvature in diastole on short-axis view normalized either partially or
completely postoperatively, resulting in decreased left ventricular
eccentricity (1.34 +/- 0.06 preop vs. 1.06 +/- 0.07 postop, p less than
0.001). Atrial septal defect closure, therefore, leads to normalization of
left ventricular geometry and in patients with evidence of mitral valve
prolapse, is associated with a decrease in the degree of prolapse.
ARTICLES
Effect of atrial septal defect repair on left ventricular geometry and degree of mitral valve prolapse
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