Impact of Persistent Iatrogenic Atrial Septal Defect following MitraClip

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

doi:10.3390/jcdd10010001

Impact of Persistent Iatrogenic Atrial Septal Defect following MitraClip

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

Research output: Contribution to journal › Article › peer-review

Abstract

Background: 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. Methods: 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. Results: 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, p = 0.875), and LV ejection fraction (51.1 ± 14.0% vs. 51.3 ± 13.9%, p = 0.933). However, patients with iASD had higher RV systolic pressure (48.7 ± 14.4 vs. 45.5 ± 14.5 mmHg, p = 0.042) compared with patients without iASD. Conclusion: 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.

Original language	English (US)
Article number	1
Journal	Journal of Cardiovascular Development and Disease
Volume	10
Issue number	1
DOIs	https://doi.org/10.3390/jcdd10010001
State	Published - Jan 2023

Keywords

echocardiography
endovascular procedures
mitral valve insufficiency

ASJC Scopus subject areas

Pharmacology, Toxicology and Pharmaceutics(all)
Pharmacology (medical)

Access to Document

10.3390/jcdd10010001

Cite this

Chao, C. J., Seri, A., Abraham, B., Farina, J. M., Fennelly, E., Campany, M., Pereyra, M., Said, E. F., Kenyon, C., Fath, A. R., Smith, S., Buckner-Petty, S., Rayfield, C. A., Fortuin, D., Sweeney, J. P., Yang, E. H., Ayoub, C., Eleid, M. F., Alkhouli, M., ... Arsanjani, R. (2023). Impact of Persistent Iatrogenic Atrial Septal Defect following MitraClip. Journal of Cardiovascular Development and Disease, 10(1), [1]. https://doi.org/10.3390/jcdd10010001

Chao, CJ, Seri, A, Abraham, B, Farina, JM, Fennelly, E, Campany, M, Pereyra, M, Said, EF, Kenyon, C, Fath, AR, Smith, S, Buckner-Petty, S, Rayfield, CA, Fortuin, D, Sweeney, JP, Yang, EH, Ayoub, C, Eleid, MF, Alkhouli, M, Rihal, CS, Holmes, DR, Pollak, PM, El Sabbagh, A, Oh, JK & Arsanjani, R 2023, 'Impact of Persistent Iatrogenic Atrial Septal Defect following MitraClip', Journal of Cardiovascular Development and Disease, vol. 10, no. 1, 1. https://doi.org/10.3390/jcdd10010001

@article{08f672bfbba045aaaac1e0991d3a2d6d,

title = "Impact of Persistent Iatrogenic Atrial Septal Defect following MitraClip",

abstract = "Background: 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. Methods: 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. Results: 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, p = 0.875), and LV ejection fraction (51.1 ± 14.0% vs. 51.3 ± 13.9%, p = 0.933). However, patients with iASD had higher RV systolic pressure (48.7 ± 14.4 vs. 45.5 ± 14.5 mmHg, p = 0.042) compared with patients without iASD. Conclusion: 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.",

keywords = "echocardiography, endovascular procedures, mitral valve insufficiency",

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

note = "Publisher Copyright: {\textcopyright} 2022 by the authors.",

year = "2023",

month = jan,

doi = "10.3390/jcdd10010001",

language = "English (US)",

volume = "10",

journal = "Journal of Cardiovascular Development and Disease",

issn = "2308-3425",

publisher = "MDPI AG",

number = "1",

}

TY - JOUR

T1 - Impact of Persistent Iatrogenic Atrial Septal Defect following MitraClip

AU - Chao, Chieh Ju

AU - Seri, Amith

AU - Abraham, Bishoy

AU - Farina, Juan M.

AU - Fennelly, Evelyn

AU - Campany, Megan

AU - Pereyra, Milagros

AU - Said, Ebram F.

AU - Kenyon, Courtney

AU - Fath, Ayman R.

AU - Smith, Sean

AU - Buckner-Petty, Skye

AU - Rayfield, Corbin A.

AU - Fortuin, David

AU - Sweeney, John P.

AU - Yang, Eric H.

AU - Ayoub, Chadi

AU - Eleid, Mackram F.

AU - Alkhouli, Mohamad

AU - Rihal, Charanjit S.

AU - Holmes, David R.

AU - Pollak, Peter M.

AU - El Sabbagh, Abdallah

AU - Oh, Jae K.

AU - Arsanjani, Reza

PY - 2023/1

Y1 - 2023/1

N2 - Background: 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. Methods: 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. Results: 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, p = 0.875), and LV ejection fraction (51.1 ± 14.0% vs. 51.3 ± 13.9%, p = 0.933). However, patients with iASD had higher RV systolic pressure (48.7 ± 14.4 vs. 45.5 ± 14.5 mmHg, p = 0.042) compared with patients without iASD. Conclusion: 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.

AB - Background: 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. Methods: 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. Results: 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, p = 0.875), and LV ejection fraction (51.1 ± 14.0% vs. 51.3 ± 13.9%, p = 0.933). However, patients with iASD had higher RV systolic pressure (48.7 ± 14.4 vs. 45.5 ± 14.5 mmHg, p = 0.042) compared with patients without iASD. Conclusion: 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.

KW - echocardiography

KW - endovascular procedures

KW - mitral valve insufficiency

UR - http://www.scopus.com/inward/record.url?scp=85146791732&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85146791732&partnerID=8YFLogxK

U2 - 10.3390/jcdd10010001

DO - 10.3390/jcdd10010001

M3 - Article

AN - SCOPUS:85146791732

SN - 2308-3425

VL - 10

JO - Journal of Cardiovascular Development and Disease

JF - Journal of Cardiovascular Development and Disease

IS - 1

M1 - 1

ER -

Impact of Persistent Iatrogenic Atrial Septal Defect following MitraClip

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this