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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.
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http://dx.doi.org/10.1002/ccd.29149 | DOI Listing |
Echocardiography
September 2025
Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Objective: To evaluate the left atrial function in pregnant women with hypertension versus those with normotension using three-dimensional speckle tracking echocardiography (3D-STE) and investigate the association between left atrial dysfunction and adverse pregnancy outcomes.
Methods: A total of 94 pregnant women registered at the Tiantan Hospital between August 2023 and October 2024 who underwent comprehensive prenatal exams were enrolled. They were divided into three groups according to their blood pressure: gestational hypertension (GH), preeclampsia (PE), and normotensive control groups.
Curr Probl Cardiol
August 2025
Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Electronic address:
Background: The clinical effect of an iatrogenic interatrial shunt in heart failure with preserved ejection fraction (HFpEF) was based on observational data, wherein decompression of the pressure-overloaded left atrium improved symptoms and hemodynamics. However, the identification of a specific patient population that may benefit remains unclear.
Methods: We searched for randomized controlled trials (RCTs) that compared the creation of interatrial shunts versus a sham procedure in patients with HFpEF.
Expert Rev Cardiovasc Ther
August 2025
Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK.
Introduction: Life expectancy is rising globally, leading to an expected increase in age-related cardiovascular diseases. Managing cardiovascular disease in older adults is particularly challenging, as these patients often face multimorbidity, polypharmacy, and increased frailty, factors independently associated with poor prognosis and a higher risk of iatrogenic complications.
Areas Covered: Atrial fibrillation (AF) is the most common tachyarrhythmia worldwide, with its prevalence projected to reach 15.
JACC Clin Electrophysiol
July 2025
Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; Interventional Electrophysiology, Scripps Clinic, La Jolla, California, USA.
Background: Persistent left atrial appendage (LAA) thrombosis in patents with contraindications or who are refractory to intensive antithrombotic therapy remains a clinical challenge. Although LAA closure with limited manipulation is performed in patients with small distal nonmobile thrombi, larger more proximal mobile thrombi are usually deemed a contraindication to percutaneous LAA closure due to the inherent risk of iatrogenic thromboembolism. In this population, percutaneous aspiration thrombectomy (AT) is a potential treatment modality.
View Article and Find Full Text PDFArch Cardiovasc Dis
August 2025
M3C-Necker, Hôpital Universitaire Necker-Enfants-Malades, AP-HP, 75015 Paris, France.
Background: Neonatal arterial thrombosis is a rare but extremely severe condition with a variable death rate.
Aim: To evaluate treatment options and outcomes in a series of hyperacute presentations of intracardiac, aortic or arterial thrombosis in neonates.
Methods: All neonates with proven aortic or arterial thrombus without iatrogenic aetiology were reviewed retrospectively in a single-centre series from January 1990 to September 2023.