Synapse
⌘+K
Synapse
PulseExploreJournal ClubResearchersJournals
Instagram
HomeJournal ClubExplore
February 19, 2026The Thoracic and Cardiovascular SurgeonOpen Access

Predictors of MR Following ASD Closure

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Preexisting mitral regurgitation can aggravate following ASD closure, but the underlying mechanisms of these adverse outcomes remain poorly understood.

Does surgical secundum ASD closure cause worsening mitral regurgitation in adults with secundum ASD?

Population

95 patients who underwent surgical secundum ASD closure

Comparison

Predictors of MR worsening vs non-worsening post-procedure

Design

Retrospective study

Follow-up

2 years

Key result

Surgical secundum ASD closure was associated with worsening mitral regurgitation in 18.95% of patients, and larger left atrial size independently predicted protection from MR worsening (OR 0.783, p=0.032).

Authors

CLChunyu LiuZZZhibiao ZhangJXJicheng Xi

Discussion

Loading...

Member takes

Overview

MR worsening in ~19% after ASD closure warrants monitoring; leaves open whether LA size guides annuloplasty in future trials.

Key Points

  • The aim is to identify predictors of worsening mitral regurgitation (MR) following atrial septal defect (ASD) closure.
  • Performed a retrospective analysis of 95 patients undergoing surgical secundum ASD closure
  • Conducted preoperative and postoperative transthoracic echocardiography (TTE)
  • Analyzed patient characteristics, including age, gender, and echocardiographic parameters
  • Utilized univariate and multiple logistic regression analyses to identify predictors
  • Age, gender, LA size, RA-VD, RA-HD, RV size, and ASD diameter are potential MR worsening predictors
  • LA size emerged as an independent predictor of MR worsening and acted as a protective factor
  • Notable reduction in right cardiac size and remodeling of LA occurred within the first 6 months post-surgery
  • Left ventricle size increased significantly over 2 years

Study Design

Type

Observational (n=95)

Multicenter

No

Structured PICO

Does surgical secundum ASD closure cause worsening mitral regurgitation in adults with secundum ASD?

P
Population
95 adult patients (mean age 37 years, 28.42% male) who underwent isolated surgical secundum atrial septal defect (ASD) closure, excluding those with concomitant procedures.
I
Intervention
Surgical secundum ASD closure (direct or patch closure)
O
Outcome
Predictors of worsening mitral regurgitation (defined as an increase in severity of MR by a grade of 1 or more following the procedure)surrogate

Main Result

Effect estimate: null

Absolute Event Rate: 18.95% vs 81.05%

p-value: p=<0.05

Left atrial size is an independent predictor of worsening mitral regurgitation following surgical secundum ASD closure, suggesting that prophylactic mitral annuloplasty may be beneficial for patients with an enlarged LA.

Limitations

  • Single-center retrospective design
  • Limited sample size (n=95)
  • No measurement of mitral annular diameter or leaflet coaptation
  • Statistical subgroup analyses were not feasible
  • Small sample size
  • Retrospective nature of the analysis
  • Did not allow for the measurement of mitral annular diameter, coaptation of the mitral leaflets, and other pertinent parameters

Cite This Study

Liu et al. (2026) conducted an observational in Secundum atrial septal defect undergoing surgical closure (n=95). Surgical secundum atrial septal defect closure vs. None (retrospective observational study) was evaluated on Worsening mitral regurgitation (increase in MR severity grade by ≥1 after ASD closure) (null, p=<0.05). Surgical secundum ASD closure was associated with worsening mitral regurgitation in 18.95% of patients, and larger left atrial size independently predicted protection from MR worsening (OR 0.783, p=0.032).

synapsesocial.com/papers/6996a768ecb39a600b3ed108https://doi.org/10.1055/a-2809-8816
View Full Paper
Ask AI
Bookmark
Share