Iatrogenic atrial septal defect does not affect acute hemodynamic modifications after transcatheter edge-to-edge repair in patients with functional mitral regurgitation
Objective: The correction of functional mitral regurgitation (FMR) with transcatheter edge-to-edge repair (TEER) can favorably affect patients’ hemodynamic profile. However, the procedure requires inter-atrial trans-septal access and the hemodynamic relevance of the residual iatrogenic atrium septal...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-05-01
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| Series: | Hellenic Journal of Cardiology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1109966622000239 |
| _version_ | 1828832109406453760 |
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| author | A. Mandurino-Mirizzi C. Raineri G. Magrini R. Frassica L. Scelsi A. Turco S. Ghio M. Ferrario L. Oltrona-Visconti G. Crimi |
| author_facet | A. Mandurino-Mirizzi C. Raineri G. Magrini R. Frassica L. Scelsi A. Turco S. Ghio M. Ferrario L. Oltrona-Visconti G. Crimi |
| author_sort | A. Mandurino-Mirizzi |
| collection | DOAJ |
| description | Objective: The correction of functional mitral regurgitation (FMR) with transcatheter edge-to-edge repair (TEER) can favorably affect patients’ hemodynamic profile. However, the procedure requires inter-atrial trans-septal access and the hemodynamic relevance of the residual iatrogenic atrium septal defect (iASD) is still debated. This study aimed at investigating the hemodynamic modifications during TEER with MitraClip, before and after the iASD creation, in patients with heart failure with reduced ejection fraction (HFrEF) and severe FMR. Methods: Thirty-nine HFrEF patients with 3+ or 4+/4+ FMR were included. Right heart catheterization was performed at baseline after general anesthesia induction and at the end of TEER, both before and after removing the device guiding catheter. Results: Compared with baseline, MitraClip positioning was followed by a significant immediate improvement in cardiac output (respectively: 3.36 vs 5.05 ml/min), pulmonary artery wedge pressure (23.7 vs 18.2 mmHg), mean pulmonary artery pressure (34.4 vs 27.7 mmHg) and pulmonary vascular resistance (3.6 vs 2.2 Wood Units) (all p < 0.001). No further significant modifications occurred after removing the device guiding catheter. Conclusions: Our data suggest that the acute hemodynamic modifications after TEER are not influenced by the induction of iASD in patients with FMR. |
| first_indexed | 2024-12-12T16:47:14Z |
| format | Article |
| id | doaj.art-311a2fbdf8484d7499300225d5d7c411 |
| institution | Directory Open Access Journal |
| issn | 1109-9666 |
| language | English |
| last_indexed | 2024-12-12T16:47:14Z |
| publishDate | 2022-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Hellenic Journal of Cardiology |
| spelling | doaj.art-311a2fbdf8484d7499300225d5d7c4112022-12-22T00:18:27ZengElsevierHellenic Journal of Cardiology1109-96662022-05-01651518Iatrogenic atrial septal defect does not affect acute hemodynamic modifications after transcatheter edge-to-edge repair in patients with functional mitral regurgitationA. Mandurino-Mirizzi0C. Raineri1G. Magrini2R. Frassica3L. Scelsi4A. Turco5S. Ghio6M. Ferrario7L. Oltrona-Visconti8G. Crimi9Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, ItalyDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, ItalyDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, ItalyDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, ItalyDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, ItalyDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, ItalyDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, ItalyDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, ItalyDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, ItalyDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Interventional Cardiology Unit, Cardio-Thoraco Vascular Department (DICATOV), IRCCS Ospedale Policlinico San Martino, IRCCS Italian Cardiovascular Network & Department of Internal Medicine, University of Genova, Genova, Italy; Corresponding author. Gabriele Crimi, MD, Interventional Cardiology Unit, Cardio-Thoraco Vascular Department (DICATOV), IRCCS Ospedale Policlinico San Martino, Largo Rossana Benzi 1, 16100, Genova, Italy. Phone +39 3479345112.Objective: The correction of functional mitral regurgitation (FMR) with transcatheter edge-to-edge repair (TEER) can favorably affect patients’ hemodynamic profile. However, the procedure requires inter-atrial trans-septal access and the hemodynamic relevance of the residual iatrogenic atrium septal defect (iASD) is still debated. This study aimed at investigating the hemodynamic modifications during TEER with MitraClip, before and after the iASD creation, in patients with heart failure with reduced ejection fraction (HFrEF) and severe FMR. Methods: Thirty-nine HFrEF patients with 3+ or 4+/4+ FMR were included. Right heart catheterization was performed at baseline after general anesthesia induction and at the end of TEER, both before and after removing the device guiding catheter. Results: Compared with baseline, MitraClip positioning was followed by a significant immediate improvement in cardiac output (respectively: 3.36 vs 5.05 ml/min), pulmonary artery wedge pressure (23.7 vs 18.2 mmHg), mean pulmonary artery pressure (34.4 vs 27.7 mmHg) and pulmonary vascular resistance (3.6 vs 2.2 Wood Units) (all p < 0.001). No further significant modifications occurred after removing the device guiding catheter. Conclusions: Our data suggest that the acute hemodynamic modifications after TEER are not influenced by the induction of iASD in patients with FMR.http://www.sciencedirect.com/science/article/pii/S1109966622000239functional mitral regurgitationTEERiatrogenic atrium septal defecttranscatheter mitral valve repair |
| spellingShingle | A. Mandurino-Mirizzi C. Raineri G. Magrini R. Frassica L. Scelsi A. Turco S. Ghio M. Ferrario L. Oltrona-Visconti G. Crimi Iatrogenic atrial septal defect does not affect acute hemodynamic modifications after transcatheter edge-to-edge repair in patients with functional mitral regurgitation Hellenic Journal of Cardiology functional mitral regurgitation TEER iatrogenic atrium septal defect transcatheter mitral valve repair |
| title | Iatrogenic atrial septal defect does not affect acute hemodynamic modifications after transcatheter edge-to-edge repair in patients with functional mitral regurgitation |
| title_full | Iatrogenic atrial septal defect does not affect acute hemodynamic modifications after transcatheter edge-to-edge repair in patients with functional mitral regurgitation |
| title_fullStr | Iatrogenic atrial septal defect does not affect acute hemodynamic modifications after transcatheter edge-to-edge repair in patients with functional mitral regurgitation |
| title_full_unstemmed | Iatrogenic atrial septal defect does not affect acute hemodynamic modifications after transcatheter edge-to-edge repair in patients with functional mitral regurgitation |
| title_short | Iatrogenic atrial septal defect does not affect acute hemodynamic modifications after transcatheter edge-to-edge repair in patients with functional mitral regurgitation |
| title_sort | iatrogenic atrial septal defect does not affect acute hemodynamic modifications after transcatheter edge to edge repair in patients with functional mitral regurgitation |
| topic | functional mitral regurgitation TEER iatrogenic atrium septal defect transcatheter mitral valve repair |
| url | http://www.sciencedirect.com/science/article/pii/S1109966622000239 |
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