الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
An ostium secundum atrial septal defect is an abnormally large opening in the atrial septum at the site of the foramen ovale and the ostium secundum. A secundum atrial septal defect can result from inadequate formation of the septum secundum so that it does not completely cover the ostium secundum. More often, the ostium secundum is excessively large because of increased resorption so that septum secundum cannot cover it. Isolated secundum atrial septal defects account for approximately 7% of congenital cardiac defects. Congenital heart defects of significance occur in approximately 8 per 1000 live births. Therefore, 5-6 cases of secundum atrial septal defect occur per 10,000 live births. This number refers only to defects that are large enough to come to clinical attention. Many small defects that remain undetected occur in addition to numerous cases of patent foramen ovale, an isolated secundum atrial septal defect rarely causes significant symptoms in pediatric patients, regardless of defect size.
Rarely, an infant may develop congestive heart failure in the presence of a secundum atrial septal defect whether the defect alone is responsible for causing heart failure is not well established, although it certainly adds to the patient’s hemodynamic difficulties. Failure to thrive caused only by a secundum atrial septal defect is, similarly, a rare occurrence.
The current study was conducted to determine the effect of the early diagnosis and ASD closure on the RIGHT ventricular function and the LEFT ventricular function as well. Twenty-nine children with a well-documented history and echocardiographic findings of isolated ASD secundum disease of significant left to right shunt, including 18 males and 11 females, ages 1 to 7.6 years (mean 5.14 ± 1.84years). This group of children was selected from those who attend the cardiology outpatient clinic in Cairo university children’s hospital.
All the 29 patients underwent full echocardiographic examination to image the heart including (M-mode, 2D TTE, Doppler, colored Doppler, TDI and 3D TTE) at the time of presentation and at 6 months after successful trans-catheter ASD closure using single Amplatzer occluder device.
All studied children were subjected to:
1. Thorough history taking: including, age, sex and residence. History of congenital heart disease was inquired about. The diagnosis was made by echocardiography. A past history of any relevant medical disorder was also inquired about.
2. Thorough clinical examination including chest, heart and abdominal examination with special emphasis on local cardiac findings.
3. Full 2D TTE before and 6 months after ASD closure.
4. Measurement of TDI Tricuspid annular plane systolic excursion (TAPSE)
5. Measurement of Right ventricular as well as Left ventricular end diastolic areas, TDI myocardial performance index (MPI), fractional area change, global longitudinal strain and E/e` ratio
Each individual was examined with a commercially available GE Vivid 3 Echo system with 3.0-MHz and 5.0MHz probes.