Transcatheter closure of patent foramen ovale associated with atrial septal aneurysm with Amplatzer Cribriform septal occluder

Abstract

Objective: We sought to evaluate the short- and longterm outcomes of Amplatzer Multi-Fenestrated Septal Occluder Cribriform (AMF) device use in the percutaneous closure of patent foramen ovale (PFO) associated with atrial septal aneurysm (ASA).

Background: Since patients with PFO, associated with ASA, are at higher risk of embolic events (EE), the AMF device might offer advantages in this subgroup of patients.

Methods: Overall, 38 consecutive patients, with both PFO and ASA, underwent percutaneous closure of the defect with the AMF device, and the results were compared to those in 38 patients with PFO and ASA treated with the Amplatzer PFO device (APO). Death due to embolism, stroke or transient ischemic attack (TIA) were considered recurrent EE. Pre- and post-intervention shunting and 6-month residual shunting were evaluated echocardiographically with intravenous contrast injection.

Results: The procedure was successfully completed in all patients in both groups. No procedure-related complications were observed during hospitalization. Immediate closure was achieved in all patients in the AMF group, whereas 3 patients in the APO group showed a small residual shunt. Residual shunting was observed at 6 months in 2 patients in the APO group. No recurrence of EE was recorded in the AMF group. Recurrent TIA was observed in 3 patients in the APO group; 2/3 patients had a small residual shunt following the procedure and at 6-month follow up.

Conclusion: The AMF device might offer advantages in terms of rate of EE recurrence or residual shunt compared to the APO device in PFO patients associated with ASA.