The Risk Factors of Mitral Regurgitation Deterioration After Secundum Atrial Septal Defect Closure
Background: Association between secundum Atrial Septal Defect (ASD) and mitral valve (MV) disease has been recognized for decades. Secundum ASD closure can reduce mitral regurgitation (MR) degree. However, in some patients, deterioration of MR after ASD closure has been observed. We aimed to identif...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2024-03-01
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| Series: | Clinical Medicine Insights: Cardiology |
| Online Access: | https://doi.org/10.1177/11795468231221420 |
| _version_ | 1797272043816747008 |
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| author | Garniswara Swandita Irsad Andi Arso Dyah Wulan Anggrahini Anggoro Budi Hartopo Cindy Elica Cipta Lucia Kris Dinarti |
| author_facet | Garniswara Swandita Irsad Andi Arso Dyah Wulan Anggrahini Anggoro Budi Hartopo Cindy Elica Cipta Lucia Kris Dinarti |
| author_sort | Garniswara Swandita |
| collection | DOAJ |
| description | Background: Association between secundum Atrial Septal Defect (ASD) and mitral valve (MV) disease has been recognized for decades. Secundum ASD closure can reduce mitral regurgitation (MR) degree. However, in some patients, deterioration of MR after ASD closure has been observed. We aimed to identify the risk factors of MR deterioration after ASD closure. Methods: This was an observational retrospective cohort study. Data were collected from the registry and echocardiogram report. We evaluated all patients with ASD closure by surgery and transcatheterization without MR intervention from January 2012 until June 2021 at Dr. Sardjito General Hospital, Yogyakarta. We excluded patients with multiple ASD and ASD with severe MR requiring MV intervention. Risk factors for MR deterioration were evaluated using multivariate logistic regression. Results: A total of 242 patients who underwent post-secundum ASD closure were included. In multivariate analysis, ASD closure by surgery, large left atrial (LA) diameter (>40 mm), low left ventricular ejection fraction (LVEF; <55%), and MV regurgitation degree were significant risk factors for MR worsening after ASD closure, with OR of 2.103 (95% CI 1.124-3.937); 2.871 (95% CI 1.032-7.985); 5.531 (95% CI 1.368-22.366); and 2.490 (95% CI 1.339-4.630) respectively. Conclusion: ASD closure by surgery, large LA diameter (>40 mm), low LVEF (<55%), and MV regurgitation degree are independent significant risk factors for MR deterioration in post-secundum ASD closure patients. In adult ASD patients with reduced LV function, it is recommended to perform balloon testing and consider fenestrated closure, as low LVEF <55% has the highest risk of causing new or deteriorating MR. |
| first_indexed | 2024-03-07T14:18:47Z |
| format | Article |
| id | doaj.art-ceed20706376439989faf23a0e49b1ee |
| institution | Directory Open Access Journal |
| issn | 1179-5468 |
| language | English |
| last_indexed | 2024-03-07T14:18:47Z |
| publishDate | 2024-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical Medicine Insights: Cardiology |
| spelling | doaj.art-ceed20706376439989faf23a0e49b1ee2024-03-06T10:03:28ZengSAGE PublishingClinical Medicine Insights: Cardiology1179-54682024-03-011810.1177/11795468231221420The Risk Factors of Mitral Regurgitation Deterioration After Secundum Atrial Septal Defect ClosureGarniswara SwanditaIrsad Andi ArsoDyah Wulan AnggrahiniAnggoro Budi HartopoCindy Elica CiptaLucia Kris DinartiBackground: Association between secundum Atrial Septal Defect (ASD) and mitral valve (MV) disease has been recognized for decades. Secundum ASD closure can reduce mitral regurgitation (MR) degree. However, in some patients, deterioration of MR after ASD closure has been observed. We aimed to identify the risk factors of MR deterioration after ASD closure. Methods: This was an observational retrospective cohort study. Data were collected from the registry and echocardiogram report. We evaluated all patients with ASD closure by surgery and transcatheterization without MR intervention from January 2012 until June 2021 at Dr. Sardjito General Hospital, Yogyakarta. We excluded patients with multiple ASD and ASD with severe MR requiring MV intervention. Risk factors for MR deterioration were evaluated using multivariate logistic regression. Results: A total of 242 patients who underwent post-secundum ASD closure were included. In multivariate analysis, ASD closure by surgery, large left atrial (LA) diameter (>40 mm), low left ventricular ejection fraction (LVEF; <55%), and MV regurgitation degree were significant risk factors for MR worsening after ASD closure, with OR of 2.103 (95% CI 1.124-3.937); 2.871 (95% CI 1.032-7.985); 5.531 (95% CI 1.368-22.366); and 2.490 (95% CI 1.339-4.630) respectively. Conclusion: ASD closure by surgery, large LA diameter (>40 mm), low LVEF (<55%), and MV regurgitation degree are independent significant risk factors for MR deterioration in post-secundum ASD closure patients. In adult ASD patients with reduced LV function, it is recommended to perform balloon testing and consider fenestrated closure, as low LVEF <55% has the highest risk of causing new or deteriorating MR.https://doi.org/10.1177/11795468231221420 |
| spellingShingle | Garniswara Swandita Irsad Andi Arso Dyah Wulan Anggrahini Anggoro Budi Hartopo Cindy Elica Cipta Lucia Kris Dinarti The Risk Factors of Mitral Regurgitation Deterioration After Secundum Atrial Septal Defect Closure Clinical Medicine Insights: Cardiology |
| title | The Risk Factors of Mitral Regurgitation Deterioration After Secundum Atrial Septal Defect Closure |
| title_full | The Risk Factors of Mitral Regurgitation Deterioration After Secundum Atrial Septal Defect Closure |
| title_fullStr | The Risk Factors of Mitral Regurgitation Deterioration After Secundum Atrial Septal Defect Closure |
| title_full_unstemmed | The Risk Factors of Mitral Regurgitation Deterioration After Secundum Atrial Septal Defect Closure |
| title_short | The Risk Factors of Mitral Regurgitation Deterioration After Secundum Atrial Septal Defect Closure |
| title_sort | risk factors of mitral regurgitation deterioration after secundum atrial septal defect closure |
| url | https://doi.org/10.1177/11795468231221420 |
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