الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Atrial septal defect (ASD) is a common congenital heart defect (CHD), with an estimated birth prevalence of 1.6 per 1000 live births. Secundum ASD (ASD II) constitutes about 75% of these defects, has a female predominance of approximately 2:1 and is frequently diagnosed in adulthood. Many patients are asymptomatic during their childhood and adolescence and start to be symptomatic ay their 3rd or 4th decades.
Atrial septal defect closure has become an established therapy that is performed in increasing numbers of adult patients. Early ASD closure results in good long-term outcome, whereas results appear less favorable when intervention is delayed until adulthood. Currently, many reports suggested that, with the exception of those with severe and irreversible pulmonary arterial hypertension, closure is beneficial to, and thus indicated in all patients with significant shunts, regardless of age and symptoms
The aim of this work is to assess the myocardial remodeling after closure of longstanding ASD in adults in the form of changes in the ventricular volume, function and mass as well as to assess the possibility of presence of focal or diffuse myocardial fibrosis in these patients.
The study was conducted on 20 adult patients presented with ASD and managed by either trans-catheter or surgical closure at Magdi Yacoub Foundation, Aswan Heart Centre, Aswan, Egypt. Follow up MRI was performed 6 months after ASD closure. Patients were scheduled for CMR between December 2017 and November 2019.
All patients were subjected to full history taking and thorough clinical assessment, chest X-ray, Echo, laboratory investigations (BNP, creatinine, hematocrit) as well as Cardiac MRI pre and post closure for assessment of ventricular volumes, function, mass as well as myocardial fibrosis by LGE and T1 mapping.