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Review
. 2017 Feb;25(2):137-142.
doi: 10.1007/s12471-016-0928-1.

Haemodynamic and functional consequences of the iatrogenic atrial septal defect following Mitraclip therapy

E A Hart  1 , K Zwart  2 , A J Teske  2 , M Voskuil  2 , P R Stella  2 , S A J Chamuleau  2 , A O Kraaijeveld  2
Affiliations
Review

Haemodynamic and functional consequences of the iatrogenic atrial septal defect following Mitraclip therapy

E A Hart et al. Neth Heart J. 2017 Feb.

Abstract

Percutaneous MitraClip placement for treatment of severe mitral regurgitation in high surgical risk patients is a commonly performed procedure and requires a transseptal puncture to reach the left atrium. The resulting iatrogenic atrial septal defect (iASD) is not routinely closed, yet the haemodynamic and functional consequences of a persisting defect are not fully understood. Despite positive effects such as acute left atrial pressure relief, persisting iASDs are associated with negative consequences, namely significant bidirectional shunting and subsequent worse clinical outcome. Percutaneous closure of the iASD may therefore be desirable in selected cases. In this review we discuss the available literature on this matter.

Keywords: Iatrogenic atrial septal defect; MitraClip; Mitral regurgitation.

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Conflict of interest statement

Conflict of interestE.A. Hart, K. Zwart, A.J. Teske, M. Voskuil, P.R. Stella, S.A.J. Chamuleau and A.O. Kraaijeveld declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
3D atrial view (a) and 3D ventricular view (b) of MitraClip in situ (arrows)
Fig. 2
Fig. 2
3D view of iatrogenic atrial septum defect (a) and display of shunt using colour Doppler (b)
See this image and copyright information in PMC

References

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