{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T06:38:54Z","timestamp":1789627134015,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T00:00:00Z","timestamp":1639699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the rate and clinical impact of a persisting iatrogenic atrial septal defect (iASD) after percutaneous left atrial appendage occlusion (LAAO).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Percutaneous LAAO is an alternative to oral anticoagulation (OAC) for the prevention of ischemic stroke and systemic embolism in patients with atrial fibrillation (AF). Data regarding incidence and persistence of iASD after LAAO procedures and its clinical relevance is scarce.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed 144 patients that underwent LAAO at our center between 2009 and 2020 who had at least one follow\u2010up including transesophageal echocardiography (TEE). Baseline clinical, procedural data and echocardiographic characteristics in patients with and without evidence of an iASD were compared. We furthermore determined the rate of iASD persistence over time and evaluated outcomes of patients with and without spontaneous iASD closure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After a median of 92 days (IQR 75\u2013108 days) after LAAO, 50 patients (50\/144, 34.7%) showed evidence of an iASD. Patients with iASD had higher CHADS\u2010VASc\u2010scores (4.9\u00b11.5\u00a0vs 4.2\u00b11.2, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.03), larger left atrial volumes (80.5\u00b130.5\u00a0ml vs 67.1\u00b119.7\u00a0ml, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.01) and were more likely to have relevant mitral regurgitation (\u2265\u00b0 II) (46.0%\u00a0vs 12.3%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001). LAAO procedures took longer (50.1\u00b124.3\u00a0vs 41.1\u00b117.8\u00a0min, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.06) in patients with a persisting iASD. Furthermore, larger device sizes were implanted (24.3\u00b13.4\u00a0mm vs 22.1\u00b12.8\u00a0mm, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.03). The presence of an iASD had no impact on RV dysfunction, thromboembolism or mortality. Spontaneous closure of an iASD was documented in 52.0% (26\/50). Hereby, similar risk factors were identified for the persistence of an iASD in follow\u2010up.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15271","type":"journal-article","created":{"date-parts":[[2021,12,18]],"date-time":"2021-12-18T04:18:18Z","timestamp":1639801098000},"page":"65-73","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Incidence, persistence, and clinical relevance of iatrogenic atrial septal defects after percutaneous left atrial appendage occlusion"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8938-9432","authenticated-orcid":false,"given":"Dominik","family":"Nelles","sequence":"first","affiliation":[{"name":"Med. Klinik und Poliklinik II \u2010 Herzzentrum Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian","family":"Vij","sequence":"additional","affiliation":[{"name":"Med. Klinik und Poliklinik II \u2010 Herzzentrum Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baravan","family":"Al\u2010Kassou","sequence":"additional","affiliation":[{"name":"Med. Klinik und Poliklinik II \u2010 Herzzentrum Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Weber","sequence":"additional","affiliation":[{"name":"Med. Klinik und Poliklinik II \u2010 Herzzentrum Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Vogelhuber","sequence":"additional","affiliation":[{"name":"Med. Klinik und Poliklinik II \u2010 Herzzentrum Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Beiert","sequence":"additional","affiliation":[{"name":"Med. Klinik und Poliklinik II \u2010 Herzzentrum Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Nickenig","sequence":"additional","affiliation":[{"name":"Med. Klinik und Poliklinik II \u2010 Herzzentrum Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Wilko","family":"Schrickel","sequence":"additional","affiliation":[{"name":"Med. Klinik und Poliklinik II \u2010 Herzzentrum Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7015-1056","authenticated-orcid":false,"given":"Alexander","family":"Sedaghat","sequence":"additional","affiliation":[{"name":"Med. Klinik und Poliklinik II \u2010 Herzzentrum Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.22.8.983"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40119-018-0106-1"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(95)00887-X"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.4022\/jafib.1729"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.110.959015"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.10.024"},{"issue":"1","key":"e_1_2_8_8_1","first-page":"4","article-title":"Percutaneous left atrial appendage occlusion: the Munich consensus document on definitions, endpoints, and data collection requirements for clinical studies","volume":"19","author":"Tzikas A","year":"2017","journal-title":"Europace : Eur Pacing, Arrhythmias, Cardiac Electrophysiol"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-018-1401-5"},{"issue":"2","key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1093\/europace\/euz258","article-title":"EHRA\/EAPCI expert consensus statement on catheter\u2010based left atrial appendage occlusion \u2010 an update","volume":"22","author":"Glikson M","year":"2019","journal-title":"Europace : Eur Pacing, Arrhythmias, Cardiac Electrophysiol"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-015-0828-1"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13140"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-019-1403-1"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.80.6.1521"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2017.11.006"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/00015385.2021.1899484"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-018-0352-0"},{"issue":"3","key":"e_1_2_8_18_1","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1093\/europace\/eup428","article-title":"Persistent iatrogenic atrial septal defect after a single\u2010puncture, double\u2010transseptal approach for pulmonary vein isolation using a remote robotic navigation system: results from a prospective study","volume":"12","author":"Rillig A","year":"2010","journal-title":"Europace : Eur Pacing, Arrhythmias, Cardiac Electrophysiol"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12279"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12663"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.07.017"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2006.04.034"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.051989"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.7326\/M19-3583"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.15271","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/echo.15271","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.15271","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T12:34:45Z","timestamp":1693226085000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.15271"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,17]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1111\/echo.15271"],"URL":"https:\/\/doi.org\/10.1111\/echo.15271","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,17]]},"assertion":[{"value":"2021-07-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}