Haemodynamic effects of patent foramen ovale and atrial septal defect closure: a comparison during percutaneous shunt closure

P>Objectives: We investigated the haemodynamic effect of percutaneous closure of an intra-atrial shunt, using non-invasive finger pressure measurements. Background: Percutaneous closure of both patent foramen ovale (PFO) and atrial septal defect (ASD) is widely practised. Currently no data are available on short-term haemodynamic changes induced by closure. Methods: Twenty-five consecutive patients (mean age 49 +/- 17 years, 10 men) who underwent a percutaneous closure of a PFO (n = 15) or ASD (n = 10) were included in this study. During the procedure blood pressure and heart rate (HR) were monitored continuously with a Finometer (R). Changes in systolic, mean, and diastolic pressure, stroke volume (SV), cardiac output (CO) and total peripheral resistance (TPR) were computed from the pressure registrations using Modelflow (R) methodology. Results: Baseline characteristics were similar for the PFO and ASD patients. After PFO closure none of the haemodynamic parameters changed significantly. After ASD closure the systolic, mean, and diastolic pressures increased 7 center dot 1 +/- 5 center dot 4 (P = 0 center dot 003), 3 center dot 8 +/- 3 center dot 5 (P = 0 center dot 007) and 2 center dot 0 +/- 3 center dot 0 mmHg (P = ns) respectively. HR decreased 5 center dot 1 +/- 5 center dot 3 beats per minute (P = 0 center dot 01). SV, CO and TPR increased 8 center dot 5 +/- 6 center dot 4 ml (13 center dot 5%; P = 0 center dot 002), 0 center dot 21 +/- 0 center dot 45 l min-1 (5 center dot 6%; P = ns) and 0 center dot 02 +/- 0 center dot 14 dynes (4 center dot 1%; P = ns) respectively. The changes in SV differ between the PFO and ASD patients (P = 0 center dot 009). Conclusions: Using non-invasive finger pressure measurements, we found that SV, mean and systolic blood pressure increased immediately after percutaneous closure of an ASD in adults, whereas the percutaneous PFO closure had no effect on haemodynamic characteristics.