Marfan syndrome with unileaflet mitral valve, moderate mitral regurgitation and atrial septal defect. An uncommon association

Mitral regurgitation (MR) associated with secundum Atrial Septal Defect (ASD) is not widely recognized but the association is not unusual. MR has been found in less than 10% of adults with large ASD which is mainly caused by mitral valve prolapse (MVP). We are reporting a case of congenital ostium secundum ASD with MVP associated with MR, review the clinical relevance of this association, and discuss the related literature. Our patient has shown dramatic improvement in symptoms and signs after ASD closure with mitral valve replacement along with improvement in tricuspid regurgitation. More general awareness of this association will further help the surgeon for better management of the patient with this rather unusual combination of lesions.University Heart Journal Vol. 12, No. 2, July 2016; 91-94

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Left atrial pressure is associated with iatrogenic atrial septal defect after mitral valve clip

Heart ◽

10.1136/heartjnl-2018-313839 ◽

2018 ◽

Vol 105 (11) ◽

pp. 864-872 ◽

Cited By ~ 2

Author(s):

Hiroki Ikenaga ◽

Atsushi Hayashi ◽

Takafumi Nagaura ◽

Satoshi Yamaguchi ◽

Jun Yoshida ◽

...

Keyword(s):

New York ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Atrial Septal Defect ◽

Septal Defect ◽

Heart Association ◽

Functional Class ◽

Systolic Pulmonary Artery Pressure ◽

New York Heart Association ◽

Iatrogenic Atrial Septal Defect

ObjectivesMitral valve (MV) clip procedure requires interatrial trans-septal puncture to access the left atrium (LA). Iatrogenic atrial septal defect (iASD) is not uncommon and may remain for a while. However, haemodynamic and echocardiographic determinants of persistent iASD are not well investigated. We sought to find haemodynamic and echocardiographic determinants of iASD after MV clip.MethodsA total of 131 patients with grades 3 to 4+ mitral regurgitation who underwent MitraClip and completed invasive haemodynamic measurement, baseline, 1 month and approximately 12 months of transthoracic echocardiography (TTE) follow-up were retrospectively reviewed.ResultsTTE at 1 month showed persistent iASD in 57% (1M-iASD). Mean LA pressure after clip was significantly higher in patients with 1M-iASD than patients without 1M-iASD (17±6 mm Hg vs 15±5 mm Hg, p=0.01). Among patients with 1M-iASD, 24 patients (35%) had persistent iASD at 12 months (12M-iASD). Mean LA pressure after clip was significantly higher in patients with 12M-iASD than patients without 12M-iASD (19±6 mm Hg vs 16±6 mm Hg, p=0.04). Patients with 12M-iASD did not significantly differ from patients without 12M-iASD in terms of right heart enlargement, estimated systolic pulmonary artery pressure, New York Heart Association functional class and brain natriuretic peptide at 12 months. Logistic regression analysis, however, showed that mean LA pressure after clip was significantly associated with persistent iASD at 12 months in patients with 1M-iASD even after adjustment for cardiac index after clip and the prevalence of mitral regurgitation ≥3+ at 12 months (OR 1.10 per 1 mm Hg, 95% CI 1.01 to 1.21, p=0.04).ConclusionsElevated LA pressure after MV clip was associated with persistent iASD.

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Mitral Valve Plasty for Mitral Regurgitation Caused by Chordal Rupture Complicated by Secundum Atrial Septal Defect—A Case Report—

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) ◽

10.3919/jjsa.81.1278 ◽

2020 ◽

Vol 81 (7) ◽

pp. 1278-1283

Author(s):

Kazuhito TATSU ◽

Toru UEZU

Keyword(s):

Case Report ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Atrial Septal Defect ◽

Septal Defect ◽

Secundum Atrial Septal Defect ◽

Mitral Valve Plasty

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A Case of "Edge-to-Edge" Mitral Valve Plasty Performed for Mitral Regurgitation Associated with Secundum Atrial Septal Defect

Japanese Journal of Cardiovascular Surgery ◽

10.4326/jjcvs.36.48 ◽

2007 ◽

Vol 36 (1) ◽

pp. 48-51

Author(s):

Atsushi Bito ◽

Noboru Murata ◽

Noboru Yamamoto

Keyword(s):

Mitral Valve ◽

Mitral Regurgitation ◽

Atrial Septal Defect ◽

Septal Defect ◽

Secundum Atrial Septal Defect ◽

Mitral Valve Plasty

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Combined transcatheter treatment of severe mitral regurgitation and secundum atrial septal defect in an inoperable patient: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytab492 ◽

2021 ◽

Author(s):

Fabian Barbieri ◽

Ulf Landmesser ◽

Mario Kasner ◽

Markus Reinthaler

Keyword(s):

Heart Failure ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Atrial Septal Defect ◽

Mitral Valve Repair ◽

Septal Defect ◽

Defect Closure ◽

Secundum Atrial Septal Defect ◽

Valve Repair ◽

Atrial Septal Defect Closure

Abstract Background Chronic mitral regurgitation is one of the most common valvular heart diseases and is associated with poor outcome. Although other structural diseases are regularly seen in such patients, concomitant atrial septal defects remain a rarity in the elderly. Case summary We report a case of an 82-year old woman with progressive right-sided heart failure due to mitral regurgitation and an atrial septal defect of secundum type, despite optimal medical therapy. Combined transcatheter mitral valve repair by utilizing a separate transseptal puncture and atrial septal defect closure was performed resulting in amelioration of symptoms. Discussion Procedural planning for simultaneous transcatheter therapies of coupled structural heart disease entities remains complex. Our case illustrates feasibility of percutaneous edge-to-edge mitral valve repair and consecutive closure of a large secundum atrial septal defect. Different options of accessing the left atrium should be discussed on an individual basis, while additional atrial septal defect closure may be beneficial in terms of right ventricular function and symptoms of right heart failure.

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