Incidence and clinical relevance of persistent iatrogenic atrial septal defect after percutaneous mitral valve repair

Abstract Percutaneous mitral valve repair (PMVR) requires transseptal puncture and results in iatrogenic atrial septal defect (iASD). The impact of persistent iASD was previously investigated. However, data were diverse and inconclusive. 53 patients who underwent MITRACLIP were retrospectively inclu...

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Autores principales:	Mhd Nawar Alachkar, Anas Alnaimi, Sebastain Reith, Ertunc Altiok, Jörg Schröder, Nikolaus Marx, Mohammad Almalla
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/674cafa3703547e888904ca3ace1287b
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spelling	oai:doaj.org-article:674cafa3703547e888904ca3ace1287b2021-12-02T17:40:49ZIncidence and clinical relevance of persistent iatrogenic atrial septal defect after percutaneous mitral valve repair10.1038/s41598-021-92255-32045-2322https://doaj.org/article/674cafa3703547e888904ca3ace1287b2021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-92255-3https://doaj.org/toc/2045-2322Abstract Percutaneous mitral valve repair (PMVR) requires transseptal puncture and results in iatrogenic atrial septal defect (iASD). The impact of persistent iASD was previously investigated. However, data were diverse and inconclusive. 53 patients who underwent MITRACLIP were retrospectively included. Based on the presence of iASD in transesophageal echocardiography (TEE) after 6 months, patients were divided in two groups (iASD group vs. non-iASD group). Impact of iASD on outcome at 6 months and at two years was evaluated. Persistent iASD was detected in 62% of patients. Independent predictors for persistent iASD were female gender and reduced left ventricular ejection fraction. At 6-month follow-up, there was no difference in reduction of NYHA class (ΔNYHA = 1.3 ± 1 in iASD group vs. 0.9 ± 1 in non-iASD group, p = 0.171). There was a significant difference in right ventricular end diastolic diameter (RVEDd) (42 ± 8 mm in iASD-group vs. 39 ± 4 mm in non-iASD group, p = 0.047). However, right ventricular systolic function (TAPSE) (14 ± 7 mm in iASD group vs. 16 ± 8 mm in non-iASD group, p = 0.176) and right ventricular systolic pressure (RVSP) (40 ± 12 mmHg in iASD group vs. 35 ± 10 mmHg in non-iASD group, p = 0.136) were still comparable between both groups. At 2 years follow-up, there was no significant difference regarding rate of rehospitalization (24% vs 15%, p = 0.425) or mortality (12% vs 10%, p = 0.941) between both groups. Incidence of persistent iASD after MITRACLIP is markedly high. Despite the increase in right ventricular diameter in patients with persistent iASD, these patients were not clinically compromised compared to patients without persistent iASD.Mhd Nawar AlachkarAnas AlnaimiSebastain ReithErtunc AltiokJörg SchröderNikolaus MarxMohammad AlmallaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Mhd Nawar Alachkar Anas Alnaimi Sebastain Reith Ertunc Altiok Jörg Schröder Nikolaus Marx Mohammad Almalla Incidence and clinical relevance of persistent iatrogenic atrial septal defect after percutaneous mitral valve repair
description	Abstract Percutaneous mitral valve repair (PMVR) requires transseptal puncture and results in iatrogenic atrial septal defect (iASD). The impact of persistent iASD was previously investigated. However, data were diverse and inconclusive. 53 patients who underwent MITRACLIP were retrospectively included. Based on the presence of iASD in transesophageal echocardiography (TEE) after 6 months, patients were divided in two groups (iASD group vs. non-iASD group). Impact of iASD on outcome at 6 months and at two years was evaluated. Persistent iASD was detected in 62% of patients. Independent predictors for persistent iASD were female gender and reduced left ventricular ejection fraction. At 6-month follow-up, there was no difference in reduction of NYHA class (ΔNYHA = 1.3 ± 1 in iASD group vs. 0.9 ± 1 in non-iASD group, p = 0.171). There was a significant difference in right ventricular end diastolic diameter (RVEDd) (42 ± 8 mm in iASD-group vs. 39 ± 4 mm in non-iASD group, p = 0.047). However, right ventricular systolic function (TAPSE) (14 ± 7 mm in iASD group vs. 16 ± 8 mm in non-iASD group, p = 0.176) and right ventricular systolic pressure (RVSP) (40 ± 12 mmHg in iASD group vs. 35 ± 10 mmHg in non-iASD group, p = 0.136) were still comparable between both groups. At 2 years follow-up, there was no significant difference regarding rate of rehospitalization (24% vs 15%, p = 0.425) or mortality (12% vs 10%, p = 0.941) between both groups. Incidence of persistent iASD after MITRACLIP is markedly high. Despite the increase in right ventricular diameter in patients with persistent iASD, these patients were not clinically compromised compared to patients without persistent iASD.
format	article
author	Mhd Nawar Alachkar Anas Alnaimi Sebastain Reith Ertunc Altiok Jörg Schröder Nikolaus Marx Mohammad Almalla
author_facet	Mhd Nawar Alachkar Anas Alnaimi Sebastain Reith Ertunc Altiok Jörg Schröder Nikolaus Marx Mohammad Almalla
author_sort	Mhd Nawar Alachkar
title	Incidence and clinical relevance of persistent iatrogenic atrial septal defect after percutaneous mitral valve repair
title_short	Incidence and clinical relevance of persistent iatrogenic atrial septal defect after percutaneous mitral valve repair
title_full	Incidence and clinical relevance of persistent iatrogenic atrial septal defect after percutaneous mitral valve repair
title_fullStr	Incidence and clinical relevance of persistent iatrogenic atrial septal defect after percutaneous mitral valve repair
title_full_unstemmed	Incidence and clinical relevance of persistent iatrogenic atrial septal defect after percutaneous mitral valve repair
title_sort	incidence and clinical relevance of persistent iatrogenic atrial septal defect after percutaneous mitral valve repair
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/674cafa3703547e888904ca3ace1287b
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Incidence and clinical relevance of persistent iatrogenic atrial septal defect after percutaneous mitral valve repair

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