الفهرس 
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Abstract
The trans-catheter closure of ASD usually has rapid impact on biventricular remodelling and functions. Whether the closure by using larger devices would affect the improvement in biventricular dimensions and functions remains an area of active research.
The aim of our study was to assess the degree of improvement in biventricular function and the relationship between these changes after transcatheter closure and device size.
This study is a prospective observational study. A total 50 patients who underwent successful ASD device closure from 2015 to 2017 in two specialized Egyptian centres: Ain Shams and Assiut University Hospitals were included in our study. Tissue Doppler imaging and two-dimensional (2-D) strain and strain rate were done for all patients at baseline. Follow up echocardiogram was done 24 hours and one-month post procedure. Correlation between the device size and echocardiographic variables was evaluated.
By the end results, there was a significant remodelling changes in LV and RV after device closure including a significant reduction in RV/LV, RVEDD, RVSP and Qp/Qs along with significant increase in TAPSE, LVEDD, LVM and LVMi. There is also, a statistically significant reduction in the RV-GLS and SR after 24 hours compared to baseline (from -23. 8±1. 1% to -21. 3±1. 1%, from -1. 2±0. 06 1/s to -1. 1±0. 05 1/s, P= 0. 004, P=0. 02). After one month follow up, LV-GLS without SR was improved significantly in comparison to 24 hours (from -22. 5±0. 8% to -24. 1±0. 7%, P= 0. 03). There was a significant reduction in the diastolic velocity of septal mitral annulus (E’) after 24 hours and one month (11. 2±0. 5 cm/s versus 9. 1±0. 4 cm/s versus 9. 1±0. 5 cm/s respectively (P = 0. 001, 0. 002)). There was no strong correlation between the device size and the change in LV-GLS between one day post procedure and baseline values (r= -0. 01, p= 0. 9) nor the changes of one-month versus baseline (r= -0. 1, p=0. 4). On the other hand, the relation between device size and RV-GLS changes did not show any correlation after 24hours and one month in comparison to baseline (r= 0. 05, p= 0. 8; r= 0. 2, p= 0. 3).
The change in diastolic velocity of the septum (E’) and device size had a significant, weak and negative correlation with the device size after 24 hours and one month (r= -0. 4, p=0. 02; r= -0. 3, p= 0. 03 respectively).