Iatrogenic Atrial Septal Defect Gradient for Intraprocedural Success After M-teer

Transcatheter mitral edge-to-edge repair (M-TEER) has become an established minimally invasive therapy for patients with severe mitral regurgitation (MR) who are at high or prohibitive surgical risk. However, accurate quantification of residual MR after M-TEER remains challenging. In this direction, the hemodynamic significance of the post-procedural iatrogenic atrial septal defect (iASD) gradient is unknown. The objective of this study is to assess the relationship between the post-procedural iASD pressure gradient and the severity of residual MR with intraprocedural echocardiographic and hemodynamic parameters.

Inclusion Criteria: * patients with high or prohibitive surgical risk and moderate-to-severe or severe symptomatic MR, despite the administration of maximally tolerated doses of guideline-directed medical therapy and, if appropriate, cardiac resynchronization therapy * patients undergoing M-TEER as a bridge to heart transplantation Exclusion Criteria: * Patients with post-procedural transmitral gradient ≥5 mmHg, * Patients with right-to-left shunt requiring iASD closure, * Patients, who decline to provide written informed consent.