Clinical Outcomes for Closure of Iatrogenic Atrial Septal Defects Following Transseptal SAPIEN Mitral Valve-in-Valve Procedures

Figures

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  Central Illustration. One-year outcomes of transseptal mitral valve-in-valve (MViV) patients with or without an iatrogenic atrial septal defect (iASD) closure using balloon-expandable valves are shown. (A) Primary analysis: study flow; (B) Primary analysis: 1-year all-cause mortality or stroke curves in patients who underwent MViV with or without iASD closure (in sites that did not perform iASD closures); (C) 1-year all-cause mortality or stroke curves in patients who underwent MViV with or without iASD closure (in sites that did perform iASD closures). HR, hazard ratio; NYHA, New York Heart Association; STS/ACC TVT, Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy.

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  Figure 1. Percentage of iatrogenic atrial septal defect (iASD) closure over mitral valve-in-valve (MViV) procedure among sites. Sites that performed at least 1 iASD closure and 5 MViV procedures over the study period were included..

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  Figure 2. One-year Kaplan-Meier all-cause mortality and stroke curves in iatrogenic atrial septal defect (iASD) closure site vs no iASD closure site mitral valve-in-valve (MViV) patients (pts). Kaplan-Meier estimates of all-cause mortality (A) and stroke (B) to 1 year in iASD closure site pts vs no iASD closure site pts who underwent MViV. HR, hazard ratio.

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  Figure 3. Primary analysis: 1-year Kaplan-Meier all-cause mortality and stroke curves. Kaplan-Meier estimates of all-cause mortality (A) and stroke (B) to 1 year in mitral valve-in-valve (MViV) patients with or without iatrogenic atrial septal defect (iASD) closure (in sites that did not perform iASD closures). CI, confidence interval; HR, hazard ratio.

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  Supplemental Figure 1. Sensitivity Analysis: 1-Year Kaplan-Meier All-Cause Mortality and Stroke Curves. Kaplan-Meier estimates of all-cause mortality (A) and stroke (B) to 1 year in MViV patients with or without iASD closure (in sites that did perform iASD closures). Abbreviations: HR, hazard ratio; iASD, iatrogenic atrial septal defect; MViV, mitral valve-in-valve

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  Supplemental Figure 2. 1-Year Kaplan-Meier All-Cause Mortality Curves in Pulmonary Hypertension Patients Kaplan-Meier estimates of all-cause mortality to 1 year in MViV patients with mean pulmonary artery pressure ≥35 mm Hg with or without iASD closure (in sites that did not perform iASD closures). Abbreviations: HR, hazard ratio; iASD, iatrogenic atrial septal defect; MViV, mitral valve-in-valve.