الفهرس 
Secundum Atrial Septal DefectOnly 14 pages are availabe for public view
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Abstract
Isolated secundum atrial septal defect (ASD) is a common congenital heart disease that accounts for about 10% of all congenital cardiac anomalies. Patients with right sided chambers dilatation as a result of volume overload across ASD require closure of the defect to prevent further dilatation, arrhythmias, pulmonary arterial hypertension, lung congestion and congestive heart failure. Transthoracic echocardiography is the gold standard noninvasive method in initial assessment and follow-up of patients. However, trans-esophageal echocardiography is essential for accurate detection of ASD size, shape, relation with adjacent rims and suitability of the defect for trans-catheter device closure. RV volume overload as a result of continuous shunting leads to increased RV functioning according to Frank starling law, So this will lead to changes in pulmonary venous flow pattern by suctioning effect through ASD as well as from systemic venous circulation. Trans-catheter device closure is considered the best alternative to surgical approach in secundum type of ASD, as it offers more than 98% success rate, best cosmetic, less hospital stay and fewer complications. The aim of this study is to evaluate the changes in pulmonary venous flow doppler before and after successful device closure of ASD. The study included 50 patients with ostium secundum ASD who come to Cardiology department, Tanta University Hospitals for trans catheter closure in the period between October 2019 and March 2021. 95 S um ar y All patients were subjected to full history taking, clinical examination, ECG, laboratory investigation, Echocardiographic examination before transference to catheterization lab for device closure. Follow up of all patients was done at zero, 1month and 3 months intervals after procedure by ECG and Echocardiography to detect any possible arrhythmias, device embolization, erosion or other possible complications. The following parameters were also recorded during their follow up visits: Pulmonary venous systolic wave (PVS), diastolic wave (PVD) and atrial reversal wave (PVar). Left ventricular Ejection Fraction, Right ventricular end diastolic dimension (RVEDD), Pulmonary artery pressure (PAP), Heart Rate, Tricuspid annular plane systolic excursion (TAPSE), all cardiac valves were assessed for normal motility and functioning and the results were: • Pulmonary venous Systolic wave : decreased • Pulmonary venous Diastolic wave : increased • Splitting of both Systolic and Diastolic wave immediately after closure. • Atrial Reversal wave : increased • RVEDD: decrease..