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Review
. 2018 Jun 17;7(12):e007146.
doi: 10.1161/JAHA.117.007146.

Patent Foramen Ovale Closure for Stroke Prevention and Other Disorders

Fareed Moses S Collado  1 , Marie-France Poulin  1 , Joshua J Murphy  1 , Hani Jneid  2 , Clifford J Kavinsky  3
Affiliations
Review

Patent Foramen Ovale Closure for Stroke Prevention and Other Disorders

Fareed Moses S Collado et al. J Am Heart Assoc. .
No abstract available

Keywords: migraine; patent foramen ovale; patent foramen ovale closure; shunt; stroke.

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Figures

Figure 1
Figure 1
Clot in transit. Transesophageal echocardiogram images (2D and 3D) showing a large thrombus (*) in the right atrium (RA) traversing a patent foramen ovale (PFO) into the left atrium (LA). The patient suffered a fatal stroke.
Figure 2
Figure 2
Intracardiac echo (ICE) showing a positive “bubble study” confirming a right‐to‐left shunt across a patent foramen ovale (PFO). Agitated saline is injected intravenously and bubbles are seen opacifying the right atrium (RA). Subsequently, bubbles are seen in the left atrium (LA) in less than 3 cardiac cycles.
Figure 3
Figure 3
Intracardiac echocardiogram (ICE) image showing a PFO measuring 6.5 mm using color Doppler.
Figure 4
Figure 4
Timeline showing important dates of patent foramen ovale (PFO) closure trials and US Food and Drug Administration (FDA) milestones in the United States. HDE indicates Humanitarian Device Exemption.
Figure 5
Figure 5
A, The Amplatzer PFO Occluder (courtesy of Abbott. ©2018 Abbott. All rights reserved) and B, the Gore Cardioform Septal Occluder (courtesy of W.L. Gore and Associates, Inc).
Figure 6
Figure 6
Fluoroscopic image of an Amplatzer PFO Occluder (top) and Gore Cardioform Septal Occluder (bottom) demonstrating a stable position in the atrial septum after release. The intracardiac echo (ICE) is seen in the right atrium. Red dotted lines represent the interatrial septum in this anteroposterior view.
Figure 7
Figure 7
Rims of the atrial septum as seen from the right atrium. Ao indicates aorta; SVC, superior vena cava; IVC, inferior vena cava; TV, tricuspid valve. Reprinted from Amin et al59 with permission. Copyright ©2006, John Wiley & Sons.
Figure 8
Figure 8
Intracardiac echocardiogram showing a patent foramen ovale (PFO) with a tunnel length of 1.15 cm.
Figure 9
Figure 9
A, Intracardiac image of balloon sizing using stop‐flow technique and (B) fluoroscopic image of an inflated sizing balloon across the patent foramen ovale (PFO).
Figure 10
Figure 10
Intracardiac echocardiogram image of the right (**) and left atrial disc (*) of an Amplatzer PFO Occluder (top) and Gore Cardioform Septal Occluder (bottom) before the release of the device. Note the splaying of the discs at the aortic rim. AV indicates aortic valve; LA, left atrium; RA, right atrium.
Figure 11
Figure 11
Intracardiac echocardiogram (ICE) image of a released Amplatzer PFO Occluder (top) (*) and Gore Cardioform Septal Occluder (bottom) (*). Agitated saline is seen in the right atrium (RA), but not in the left atrium (LA), confirming the absence of right to left shunt after device deployment.
Figure 12
Figure 12
A, Fluoroscopic and (B) ICE images showing a trapped defibrillator lead in between the right atrial disc and the interatrial septum. ICE indicates intracardiac echocardiogram.
Figure 13
Figure 13
Transesophageal echocardiogram (midesophageal at 180 degrees) showing a thrombus (*) attached to the left atrial disc of an Amplatzer PFO occluder (**). LA indicates left atrium; RA, right atrium.
See this image and copyright information in PMC

References

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