J Cardiovasc Med (Hagerstown). 2014 Apr;15(4):343-9. doi: 10.2459/JCM.0000000000000006.
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.
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.
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.
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.
我们旨在评估接受 MitraClip 系统治疗后持续存在房间隔交通（IAC）的患者的血液动力学后果和所采用的治疗方法。
从 2012 年 1 月至 2013 年 3 月，连续 28 例患者（平均年龄 74 +/- 8 岁）接受了经导管 MitraClip 修复术，作为评估 IAC 的正在进行的前瞻性研究的一部分。
急性手术成功率为 100%，报告的 30 天存活率为 97%。在手术后立即，所有患者均存在残余 IAC，平均直径为 0.51 +/- 0.39 cm。在 30 天时，81%的患者检测到 IAC，直径为 0.45 +/- 0.31 cm（P = 0.53）。迄今为止，有 3 名患者因残余 IAC 而出现不同程度的血液动力学损害，需要经皮关闭缺陷。
必须确定早期识别有害残余 IAC 的解剖和血液动力学标准，以便选择那些从房间隔缺损闭合中获益最大的患者。
