Details

Autor(en) / Beteiligte

• Chao, Chieh-Ju
• Seri, Amith
• Abraham, Bishoy
• Farina, Juan M
• Fennelly, Evelyn
• Campany, Megan
• Pereyra, Milagros
• Said, Ebram F
• Kenyon, Courtney
• Fath, Ayman R
• Smith, Sean
• Buckner-Petty, Skye
• Rayfield, Corbin A
• Fortuin, David
• Sweeney, John P
• Yang, Eric H
• Ayoub, Chadi
• Eleid, Mackram F
• Alkhouli, Mohamad
• Rihal, Charanjit S
• Holmes, David R
• Pollak, Peter M
• El Sabbagh, Abdallah
• Oh, Jae K
• Arsanjani, Reza

Titel

Impact of Persistent Iatrogenic Atrial Septal Defect following MitraClip

Ist Teil von

• Journal of cardiovascular development and disease, 2022-12, Vol.10 (1), p.1

Ort / Verlag

Switzerland: MDPI AG

Erscheinungsjahr

2022

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Prior studies have reported conflicting results of persistent iatrogenic atrial septal defect (iASD) and its impact following a transcatheter edge-to-edge repair (TEER) procedure. This study aims to evaluate the incidence of iASD and its clinical and hemodynamic impact after a TEER. Consecutive patients who underwent a TEER procedure from June 2014 to September 2020 at the Mayo Clinic were identified. The presence of iASD was retrospectively identified on post-procedure transthoracic echocardiography (TTE) to group patients into an iASD+ group and an iASD- group for comparison of prognosis and cardiac function. A total of 316 patients were included; the mean age was 79.1 ± 9.1 years, and 67.7% were male. Persistent iASD was diagnosed in 108 (34.2%) patients. There was no difference concerning all-cause mortality, heart failure hospitalization, and stroke/TIA between groups at follow-up (median follow-up of 9 months). Post-procedure TTE demonstrated no differences regarding right ventricle (RV) and left ventricle (LV) dimensions and function, including TAPSE (15.2 ± 4.6 vs. 15.4 ± 5.5 mm, = 0.875), and LV ejection fraction (51.1 ± 14.0% vs. 51.3 ± 13.9%, = 0.933). However, patients with iASD had higher RV systolic pressure (48.7 ± 14.4 vs. 45.5 ± 14.5 mmHg, = 0.042) compared with patients without iASD. Notwithstanding higher RV pressures, patients with persistent iASD had no hemodynamic compromise and an equal prognosis compared with those without a residual atrial defect after a TEER procedure. These findings support the mid-term safety of procedures in which an interatrial defect needs to be created and would argue against the need for interventional closure.