Key result
Percutaneous iASD closure after TEER instantly improves severe hypoxemia and patient stability.
Why the study?
The clinical significance and optimal management of persistent iatrogenic atrial septal defect following transseptal access during TEER remain unclear, particularly from a long-term perspective.
Does percutaneous closure of an iatrogenic atrial septal defect improve acute hypoxemia due to right-to-left shunt following transcatheter edge-to-edge mitral valve repair?
Case Report (n=1)
Does percutaneous closure of an iatrogenic atrial septal defect improve acute hypoxemia due to right-to-left shunt following transcatheter edge-to-edge mitral valve repair?
Immediate percutaneous closure of an iatrogenic atrial septal defect following transcatheter edge-to-edge mitral valve repair can rapidly resolve acute hypoxemia caused by a right-to-left interatrial shunt.
Persistent iASD after TEER may carry long-term risks in select patients; leaves open optimal surveillance and closure strategies.
Transcatheter edge-to-edge mitral valve repair (TEER) is an established alternative for patients with severe, symptomatic mitral regurgitation (MR) at high surgical risk. The TEER procedure requires transseptal access, therefore might lead to the development of persistent iatrogenic atrial septal defect (iASD). The clinical significance of iASD and optimal management particularly from a long-term perspective is not clear. Herein, we described a case report of a 76-year-old female with prior left atrial appendage occlusion and severe MR that underwent a TEER procedure using MitraClip® (MC) system. After the MC implantation, she developed acute hypoxemia due to interatrial right-to-left shunt and required immediate iASD closure.
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Ratajczak et al. (2022) conducted a case report in Severe mitral regurgitation and iatrogenic atrial septal defect with hypoxemia (n=1). Percutaneous closure of iatrogenic atrial septal defect was evaluated on Improvement of hypoxemia and oxygen saturation. Percutaneous closure of an iatrogenic atrial septal defect following transcatheter edge-to-edge mitral valve repair led to instant improvement of severe hypoxemia and stabilization of the patient.
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