title: When to close iatrogenic atrial septal defect after percutaneous edge to edge repair of mitral valve regurgitation.
abstract: Transseptal puncture is increasingly utilized in electrophysiology and interventional cardiology. With a wide range of therapeutic indications, incidence of iatrogenic atrial septal defect (iASD) is likely to increase. However, the clinical and hemodynamic significance of iatrogenic atrial septal defect is not clear. We report a case of an 88year old woman with prior transcatheter aortic valve implantation and symptomatic severe degenerative mitral regurgitation. She developed persistent hypoxemia following MitraClip(®) procedure, requiring closure of iASD resulting in immediate recovery of hemodynamics. In here, we discuss the hemodynamic changes following percutaneous mitral valve repair and review the evidence supporting the closure of iatrogenic atrial septal defects.
authors.affiliation: Division of Cardiology, Creighton University School of Medicine, Omaha, NE. Electronic address: sat_cp@hotmail.com.
authors.forename: Satish
authors.initials: S
authors.lastname: Chandraprakasam
authors.affiliation: Heart and Vascular Specialists, CHI Alegent Creighton Health, Omaha, NE.
authors.forename: Ruby
authors.initials: R
authors.lastname: Satpathy
mesh_terms: D000369:Aged, 80 and over; D054087:Atrial Septum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000503:physiopathology; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D005260:Female; D006335:Heart Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics; D006801:Humans; D007049:Iatrogenic Disease; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D020127:Recovery of Function; D019233:Retreatment; D055989:Septal Occluder Device; D016896:Treatment Outcome
keywords: Iatrogenic atrial septal defect; Shunting; Trans septal puncture; Transesophageal echocardiography