A retrospective study: elevation of cardiac troponin T after transcatheter closure of the interatrial septum is related to device size and procedural duration

Background Limited data are available on the increase in cardiac troponin after transcatheter closure of interatrial septal defects, and the mechanism is not fully understood. The aim with the study was to examine retrospectively whether transcatheter closure of the interatrial septum leads to myocardial injury, and to determine the mechanism. Methods Troponin T (TnT) serum concentrations were determined before and 1 day after transcatheter closure of an atrial septal defect (ASD) or patent foramen ovale (PFO) in a retrospective study in adults. Fifty-one patients were included, 36 ASD and 15 PFO (female/male 35/16), mean age 52 ± 16 y (range 17–80 y). Results An increase in TnT was observed 1 day after the procedure ( p = 0.000) in 44 patients (92%). The increase in TnT was significantly correlated to the size of the ASD ( r = 0.424, p = 0.010), as well as to the size of the implanted ASD device ( r = 0.542, p = 0.001), and the duration of the ASD intervention ( r = 0.348, p = 0.035). In cases of PFO, the increase in TnT was not correlated with the size of the PFO or the PFO device, or the duration of the intervention. No correlations were found between the increase in TnT and the patient’s age, body weight or body surface area. Conclusions Transcatheter closure of the interatrial septum causes an increase in TnT indicating a minor and clinically insignificant myocardial injury. The findings indicate that mechanical trauma caused by inserting the ASD device may play an important role in this elevation. The impact of the size of the device on the degree of TnT elevation reflects the amount of myocardium affected by the device. Trial registration NCT03099967 . Registered 4 April 2017, retrospectively registered.