Iatrogenic atrial septal defects after transseptal puncture for percutaneous left atrial appendage occlusion and their hem-odynamic effects
Ioannis Drosos1
Roberta De Rosa1
Philipp C.Seppelt1
Sebastian Cremer1
Silvia Mas-Peiro2
Katrin Hemmann1
Jana Oppermann1
Recha Blessing3
Mariuca Vasa-Nicotera4
Andreas M.Zeiher1
Zisis Dimitriadis1
1.Division of Cardiology,Department of Medicine Ⅲ,University Hospital Frankfurt,Goethe University Frankfurt am Main,Frankfurt,Germany2.Division of Cardiology,Department of Medicine Ⅲ,University Hospital Frankfurt,Goethe University Frankfurt am Main,Frankfurt,Germany;German Center for Cardiovascular Research(DZHK),Berlin,Germany;Cardiopulmonary Institute(CPI),Frankfurt,Germany3.Center of Cardiology,University Medical Center Mainz,Mainz,Germany4.Di-vision of Cardiology and Intensive Care,Department of Internal Medicine,St.Ansgar Hospital,H?xter,Germany
摘要：Background Percutaneous left atrial appendage occlusion (LAAO) requires puncture of the interatrial septum. The immediate hemodynamic effects of iatrogenic atrial septal defects (iASD) after LAAO have not been examined so far. We aimed at evaluat-ing these effects through invasive measurements of pressure and oxygen saturation. Moreover, we assessed the incidence of per-sistent iASD at three months. METHODS Forty-eight patients scheduled for percutaneous LAAO were prospectively included in the study. Pressure and oxygen saturation were measured (1) in the right atrium (RA) before transseptal puncture, (2) in the left atrium (LA) through the transseptal sheath after transseptal puncture, (3) in the LA after removal of introducer sheath, and (4) in the RA after removal of introducer sheath. Transesophageal echocardiography was performed at three months to detect iASD. RESULTS Pressure in the RA increased significantly after removing the introducer sheath (P = 0.034), whereas no difference was found in oxygen saturation in the RA (P = 0.623). Pressure measurement in the LA showed no significant difference after re-moving the introducer sheath (P = 0.718). Oxygen saturation in the LA also showed no significant difference (P = 0.129). Follow-up transesophageal echocardiogram at 3 months revealed a persistent iASD in 4 patients (8.5 ％). CONCLUSIONS Our study suggests that iASD after percutaneous LAAO does not result in significant shunts directly after the procedure, although a significant increase of mean right atrial pressure can be observed. Persistent iASDs after percutaneous LAAO seem to be relatively rare at three months.
机标关键词：percutaneousafterappendageatrialdefectseffectshem-odynamiciatrogenic
论文发表日期：2022-09-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：10( 675-684 )