Patent oval foramen transcatheter closure: results of a strategy based on tailoring the device to the specific patient's anatomy
- PMID: 20219151
- DOI: 10.1017/S1047951109990631
Patent oval foramen transcatheter closure: results of a strategy based on tailoring the device to the specific patient's anatomy
Abstract
Background: Usually the literature results for device-closure of patent oval foramen concern a single type of device or different devices implanted without anatomical preferences. We propose a strategy of device type and selection based on intra-cardiac echocardiography measurements of inter-atrial septum characteristics.
Methods: We prospectively enrolled 100 consecutive patients with a mean age of 43 plus or minus 15.5 years, 68 females, who had been referred to our centre for catheter-based closure of inter-atrial shunts over a 48-month period. On the basis of intra-cardiac echocardiography findings the operators selected the Amplatzer Occluder family (AGA Medical Corporation) or the Premere Closure System (St Jude Medical Inc.). Determinants of the selection process were presence and extension of atrial septal aneurysm, tunnel length, rims length, and thickness, presence of additional fenestrations.
Results: According on intra-cardiac echocardiography study, 26 patients have a long channel patent oval foramen, 44 patients had a large atrial septal aneurysm (more than four RL), 24 patients had a moderate atrial septal aneurysm (more than two RL but less than four right-to-left), and six patients had hypertrophic rims. Thus, the Amplatzer PFO Occluder was selected in 24 patients, the Amplatzer ASD Cribriform Occluder in 44 patients, and the Premere device in 32 cases. No aortic erosions, device thrombosis, or recurrent ischaemic cerebral events were observed. Pre-discharge and follow-up occlusion rates were 91% and 96%, respectively.
Conclusions: Our study suggested that such strategy driven from identification and measurements of the right atrium and inter-atrial septum components resulted in low complications and high-success rates, mandatory conditions when facing with otherwise healthy subjects, such as the patients with patent oval foramen.
Similar articles
-
Transcatheter patent foramen ovale closure is effective in reducing migraine independently from specific interatrial septum anatomy and closure devices design.Cardiovasc Revasc Med. 2010 Jan-Mar;11(1):29-33. doi: 10.1016/j.carrev.2008.04.002. Cardiovasc Revasc Med. 2010. PMID: 20129358
-
An aneurysmal interatrial septum with a patent foramen ovale and multiple fenestrations closed by a single occluder device.Acta Med Iran. 2012;50(10):713-6. Acta Med Iran. 2012. PMID: 23275290
-
Medium-term results of transcatheter closure of patent foramen ovale (PFO) with Amplatzer PFO and Cribriform occluders.Kardiol Pol. 2012;70(11):1142-6. Kardiol Pol. 2012. PMID: 23180522
-
Echocardiographic evaluation of patent foramen ovale prior to device closure.JACC Cardiovasc Imaging. 2010 Jul;3(7):749-60. doi: 10.1016/j.jcmg.2010.01.007. JACC Cardiovasc Imaging. 2010. PMID: 20633854 Review.
-
Three-dimensional imaging of the atrial septum and patent foramen ovale anatomy: defining the morphological phenotypes of patent foramen ovale.Eur J Echocardiogr. 2010 Dec;11(10):i19-25. doi: 10.1093/ejechocard/jeq122. Eur J Echocardiogr. 2010. PMID: 21078835 Review.
Cited by
-
Outcomes of Device Closure of Atrial Septal Defects.Children (Basel). 2020 Aug 25;7(9):111. doi: 10.3390/children7090111. Children (Basel). 2020. PMID: 32854325 Free PMC article. Review.
-
Patent Foramen Ovale Percutaneous Closure: Evolution and Ongoing Challenges.J Clin Med. 2023 Dec 21;13(1):54. doi: 10.3390/jcm13010054. J Clin Med. 2023. PMID: 38202061 Free PMC article. Review.
-
PFO closuRE and CryptogenIc StrokE (PRECISE) registry: a multi-center, international registry.Clin Res Cardiol. 2012 Oct;101(10):787-93. doi: 10.1007/s00392-012-0458-9. Epub 2012 Apr 10. Clin Res Cardiol. 2012. PMID: 22487724
-
Long-term results of the amplatzer cribriform occluder for patent foramen ovale with associated atrial septal aneurysm: impact on occlusion rate and left atrial functional remodelling.Am J Cardiovasc Dis. 2012;2(1):68-74. Epub 2011 Dec 15. Am J Cardiovasc Dis. 2012. PMID: 22254216 Free PMC article.
-
Anatomo-functional characterization of interatrial septum for catheter-based interventions.Am J Cardiovasc Dis. 2011;1(3):227-35. Epub 2011 Aug 10. Am J Cardiovasc Dis. 2011. PMID: 22254200 Free PMC article.
MeSH terms
LinkOut - more resources
Full Text Sources
Miscellaneous