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Case Reports
. 2010;37(5):553-6.

Transhepatic approach to closure of patent foramen ovale: report of 2 cases in adults

Jamal Hussain  1 , Robert Strumpf, Aslan Ghandforoush, Ayman Jamal, Edward Diethrich
Affiliations
Case Reports

Transhepatic approach to closure of patent foramen ovale: report of 2 cases in adults

Jamal Hussain et al. Tex Heart Inst J. 2010.

Abstract

Patent foramen ovale is increasingly diagnosed in patients who are undergoing clinical study for cryptogenic stroke or migraine. In addition, patent foramen ovale is often suspected as a cause of paradoxical embolism in patients who present with arterial thromboembolism. The femoral venous approach to closure has been the mainstay. When the femoral approach is not feasible, septal occluder devices have been deployed via a transjugular approach.Herein, we describe 2 cases of patent foramen ovale in which the transhepatic approach was used for closure. To our knowledge, this is the 1st report of a transhepatic approach to patent foramen ovale closure in an adult patient. Moreover, no previous case of patent foramen ovale closure has been reported in a patient with interrupted inferior vena cava.

Keywords: Brain ischemia/etiology; echocardiography, transesophageal; embolism, paradoxical/etiology/prevention & control; heart catheterization/methods; heart defects, congenital/therapy; hepatic veins; migraine disorders; patent foramen ovale; platypnea-orthodeoxia syndrome; prosthesis implantation/methods.

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Figures

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Fig. 1 A) Transesophageal color-flow echocardiographic image shows flow (arrow) through the patent foramen ovale (PFO) with right-to-left shunt. B) Supra Core® wire is seen across the PFO. C) AMPLATZER® sheath (arrow) is stationed in the left atrium, across the PFO.
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Fig. 2 Transesophageal echocardiography. A) Left atrial disc is deployed (arrow). B) Both discs are deployed (arrows) across the septum, before their final release from the delivery cable. C) Minnesota wiggle: “pull and push” maneuver (arrow) on the delivery cable. D) Final device deployment. No shunting into the left atrium (arrow) is evident upon color-flow Doppler imaging. The device appears to be well seated.
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Fig. 3 Patient 1. A) The azygos vein drains into the superior vena cava. B) The inferior vena cava (IVC) continues as the azygos vein, after interruption by both renal veins (white arrows), which drain into the IVC.
See this image and copyright information in PMC

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References

    1. Lechat P, Mas JL, Lascault G, Loron P, Theard M, Klimczac M, et al. Prevalence of patent foramen ovale in patients with stroke. N Engl J Med 1988;318(18):1148–52. - PubMed
    1. Anzola GP, Magoni M, Guindani M, Rozzini L, Dalla Volta G. Potential source of cerebral embolism in migraine with aura: a transcranial Doppler study. Neurology 1999;52(8): 1622–5. - PubMed
    1. Martin F, Sanchez PL, Doherty E, Colon-Hernandez PJ, Delgado G, Inglessis I, et al. Percutaneous transcatheter closure of patent foramen ovale in patients with paradoxical embolism. Circulation 2002;106(9):1121–6. - PubMed
    1. Sader MA, De Moor M, Pomerantsev E, Palacios IF. Percutaneous transcatheter patent foramen ovale closure using the right internal jugular venous approach. Catheter Cardiovasc Interv 2003;60(4):536–9. - PubMed
    1. Rao PS, Palacios IF, Bach RG, Bitar SR, Sideris EB. Platypnea-orthodeoxia: management by transcatheter buttoned device implantation. Catheter Cardiovasc Interv 2001;54(1):77–82. - PubMed

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