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Hemodynamic patterns of residual interatrial communication after transcatheter MitraClip repair

Ussia, Gian Paolo; Cammalleri, Valeria; Marchei, Massimo; Sergi, Domenico; De Vico, Pasquale; Muscoli, Saverio; Sarkar, Kunal; Romeo, Francesco

Journal of Cardiovascular Medicine: April 2014 - Volume 15 - Issue 4 - p 343–349
doi: 10.2459/JCM.0000000000000006
Original articles: Interventional cardiology
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Aims We sought to assess the hemodynamic sequel and the therapy adopted in patients treated with MitraClip system, who experienced a persistent interatrial communication (IAC) after the procedure.

Methods From January 2012 to March 2013, 28 consecutive patients (mean age 74 ± 8 years) underwent transcatheter MitraClip repair, as part of an ongoing prospective study to assess the IAC.

Results Acute procedural success was 100% and a 30-days survival of 97% was reported. Immediately after the procedure, a residual IAC was present in all patients with an average diameter of 0.51 ± 0.39 cm. At 30 days, IAC was detected in 81% of patients with a diameter of 0.45 ± 0.31 cm (P = 0.53). To date, three patients developed different hemodynamic impairment secondary to the residual IAC, requiring percutaneous closure of the defect.

Conclusion Anatomic and hemodynamic criteria for early recognition of harmful residual IAC have to be identified, in order to select those patients who are benefited the most from atrial septal defect closure.

aDepartment of Cardiovascular Disease

bDepartment of Anesthesiology, Tor Vergata University of Rome, Rome, Italy

Correspondence to Gian Paolo Ussia, Department of Cardiovascular Disease, Tor Vergata University of Rome, Viale Oxford, 81 00133 Rome, ItalyTel: +39 0620904009; fax: +39 0620904008; e-mail: gpussia@hotmail.com

Received 8 May, 2013

Revised 19 January, 2014

Accepted 19 January, 2014

© 2014 Italian Federation of Cardiology. All rights reserved.