الفهرس 
Congenital Heart Disease (CHD)Only 14 pages are availabe for public view
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Abstract
Background: Atrial septal defects belong to a group of congenital cardiac anomalies that allow communication between the left and right sides of the heart. These interatrial communications include several distinct defects in the cardiac terminations of the systemic and pulmonary veins (sinus venosus and coronary sinus defects) and in the interatrial septum (atrial septal defects).
Functional tricuspid regurgitation (TR) can occur secondary to ASD-based volume-overload due to right heart- and tricuspid annular dilatation. Percutaneous ASD closure may improve functional TR by reverse remodeling and prevent further right heart deterioration from volume to eventual pressure overload.
Aim of study: To evaluate predictors of residual moderate to severe tricuspid regurgitation after percutaneous transcatheter ASD device closure to identify patients with ASD in whom regression of Tricuspid regurgitation is unlikely after successful ASD device closure.
Patients and Methods: Patients presented to Congenital and structural heart disease unit of cardiology department Ain shams university hospitals for elective percutaneous transcatheter device closure of Atrial septal defect. The patients were recruited during the period from September 2022 to march 2023. 30 patients was included in our study after being diagnosed with ASD by Transthoracic and trans-esophageal echocardiography and planned for elective percutaneous transcatheter device closure of ASD based on recommendations of European Society of cardiology guidelines of adult congenital heart disease published in 2020.
The entire study population was evaluated via 2D & 3D echocardiography.
Results: Our study assessed the RV remodelling and residual TV regurgitation after ASD closure by 3D echocardiography. The results of our study showed that a significant decrease in right ventricular systolic pressure with a p-value of <0.001. A significant decrease in tricuspid annulus plane systolic excursion with a p-value of 0.016 and a significant increase in ejection fraction with 3D ECHO with a p-value of 0.004 at 3 months post-closure.the 3D RVESV index was significantly decreased with a p-value of <0.001 and shows an accuracy of 60.3% as a predictor of RV remodeling with a cutoff point of >38. The 3D RVEDV index was significantly decreased with a p-value of <0.001 and shows an accuracy of 64.6% with a cutoff point of ≤64.A significant decrease in tricuspid valve tenting volume with a p-value of <0.001 and shows an accuracy of 65.3% with a cutoff point of ≤0.9. A significant decrease in tricuspid valve tenting height with a p-value of <0.001 and shows an accuracy of 70.3% with a cutoff point of ≤0.7.A significant decrease in tricuspid valve annulus diameter by 3D ECHO assessment with a p-value of <0.001 and shows an accuracy of 53.6% with a cutoff point of ≤5.6, and a significant decrease in tricuspid valve annulus diameter with 2D ECHO with a p-value of 0.005 and at the 3-month follow-up after closure.
Conclusion: 3D ECHO appears to facilitate accurate assessment of RV function and residual TV regurgitation for reverse remodeling after ASD closure.