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 preoperatively. 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 resect to the mitral ring. The mitral valve prolapse group had an MVAS of 0.3 ± 3.1 units (means ± SEM) preoperatively, while the group without mitral valve prolapse had an MVAS of 12.5 ± 3.1 units (p < 0.02). Postoperatively, prolapse either decreased in degree or was abolished in six of seven patients (86%), associated with an increased in MVAS to 14.7 ± 4.4 units (P < 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 < 0.001). Atrial septal 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.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)