Iatrogenic atrial septal defect following the MitraClip procedure: A state-of-the-art review

With an increase in number of patients undergoing percutaneous treatment of severe mitral regurgitation with MitraClip placement, the consequences of transseptal puncture resulting in iatrogenic atrial septal defects (iASDs) are being increasingly realized. Closure of iASDs following MitraClip therapy is not routinely performed, and no guidelines currently exist in managing this condition. While immediate hemodynamic and clinical compromise secondary to acute hypoxemia related to iASDs should be acutely managed with defect closure, the prevalence and consequences of long-term iASDs are still unclear. Some studies have cited a potential improvement in hemodynamic outcomes as a result of iASDs; while others report potential inferior and even fatal outcomes. In this state-of-the-art clinical review, we present the readers with the current data on the prevalence, outcomes, and potential management options of iASDs after MitraClip placement.