关闭房缺后的左心室功能.pdf

C 2010, the Authors Journal compilation C 2010, Wiley Periodicals, Inc. DOI: 10.1111/j.1540-8175.2009.01100.x EDITORIAL Left Ventricular Function after Percutaneous Occlusion of Atrial Septal Defects P. Syamasundar Rao, M.D. and Steven Lorch, M.D. Department of Pediatrics, Division of Pediatric Cardiology, The University of Texas-Houston Medical School/Children’s Memorial Hermann Hospital, Houston, Texas (Echocardiography 2010;27:351-353) Following reports by King, Rashkind and their left-to-right shunt, there may be chronic under- colleagues1–6 of their pioneering investigations loading of the left ventricle (LV). The larger the in mid 1970s of transcatheter device occlusion left-to-right shunt, the stiffer the left ventricular of secundum atrial septal defects (ASDs), sev- (LV) chamber becomes. While this is not prob- eral other investigators have designed and tested lematic in children and young adults, elderly pa- other devices as reviewed elsewhere.7,8 Detailed tients tend to have congestive heart failure or de- review of independently conducted clinical trials velop pulmonary edema after ASD closure.13 This revealed similar results with regard to the feasi- appears to be related to reduced LV diastolic elas- bility, safety and effectiveness of all devices ex- ticity which may be age-related, due to chronic amined.9,10 Some devices have advantages with LV under-loading and/or co-morbidities such as some aspects and other with another. Some of hypertension, ischemic heart disease, or renal dis- the devices have been d