Key result
MitraClip repair in an ASD patient leads to severe hemodynamic complications requiring intraprocedural closure.
Case Report (n=1)
Transcatheter edge-to-edge mitral valve repair in patients with a pre-existing congenital atrial septal defect can precipitate severe hemodynamic collapse requiring immediate defect closure.
May warrant intraprocedural ASD closure during MitraClip in select cases; leaves open hemodynamic effects of congenital ASD after repair.
Transcatheter edge-to-edge mitral valve repair with MitraClip System (Abbott Vascular, Menlo Park, CA) needs a trans-septal access for positioning the 22-Fr guiding catheter in the left atrium. To the best of our knowledge no data are currently available about the hemodynamic consequences of a congenital atrial septal defect (ASD) after MitraClip repair. We report a case of MitraClip repair in a patient with ostium secundum ASD and ischemic cardiomyopathy, who needed intraprocedural closure of the defect for serious hemodynamic complications, secondary to worsening of the right ventricular function, increased pulmonary pressure and inversion of the interatrial shunt in right-to-left direction. These events, which were exacerbated by high blood levels of PaCO2 for the anesthesiological protocol used, led to left-side low-output syndrome and cardiorespiratory arrest.
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Cammalleri et al. (2015) conducted a case report in Ostium secundum ASD and ischemic cardiomyopathy (n=1). MitraClip repair was evaluated on Hemodynamic complications. MitraClip repair in a patient with a congenital atrial septal defect led to serious hemodynamic complications requiring intraprocedural closure of the defect.
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