Hart E A, Zwart K, Teske A J, Voskuil M, Stella P R, Chamuleau S A J, Kraaijeveld A O
Department of Cardiology, division Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands.
Neth Heart J. 2017 Feb;25(2):137-142. doi: 10.1007/s12471-016-0928-1.
Percutaneous MitraClip placement for treatment of severe mitral regurgitation in high surgical risk patients is a commonly performed procedure and requires a transseptal puncture to reach the left atrium. The resulting iatrogenic atrial septal defect (iASD) is not routinely closed, yet the haemodynamic and functional consequences of a persisting defect are not fully understood. Despite positive effects such as acute left atrial pressure relief, persisting iASDs are associated with negative consequences, namely significant bidirectional shunting and subsequent worse clinical outcome. Percutaneous closure of the iASD may therefore be desirable in selected cases. In this review we discuss the available literature on this matter.
对于手术风险高的严重二尖瓣反流患者，经皮二尖瓣夹合术是一种常用的治疗方法，该手术需要经房间隔穿刺进入左心房。由此产生的医源性房间隔缺损（iASD）通常不进行闭合，但持续性缺损的血流动力学和功能后果尚未完全明确。尽管持续性iASD有诸如急性左心房压力减轻等积极作用，但它也与不良后果相关，即显著的双向分流和随后更差的临床结局。因此，在某些特定情况下，经皮闭合iASD可能是可取的。在这篇综述中，我们讨论了关于这个问题的现有文献。
