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Case Reports
. 2021 Feb 11;9(4):1929-1932.
doi: 10.1002/ccr3.3906. eCollection 2021 Apr.

Use of the NobleStitch™ EL for the treatment of patients with residual right-to-left shunt following device closure of PFO

Nadia Chaudhry-Waterman  1 , Stephen Shapiro  1 , James Thompson  1   2
Affiliations
Case Reports

Use of the NobleStitch™ EL for the treatment of patients with residual right-to-left shunt following device closure of PFO

Nadia Chaudhry-Waterman et al. Clin Case Rep. .

Abstract

The unique design of the NobleStitch™ EL allows it to be used to close residual defects following failed device PFO closure without impacting the integrity of previously placed double-disk Gore occluders.

Keywords: Heartstitch; cryptogenic stroke; patent foramen ovale; platypnea‐orthodeoxia syndrome; residual shunt.

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Conflict of interest statement

None declared.

Figures

FIGURE 1
FIGURE 1
Fluoroscopy during cardiac catheterization shows interatrial communication and residual shunt. Left: Residual shunting demonstrated by contrast‐enhanced fluoroscopy showing contrast crossing over interatrial septum at the superior border of the previously placed double‐disk device. Right: Sizing balloon positioned at the superior border of the previously placed double‐disk device measured a 4 mm residual defect
FIGURE 2
FIGURE 2
Intracardiac echocardiogram (ICE) displays interatrial septum before and after NobleStitch™ EL placement. Left: ICE from case 1 shows positive bubble study, with “snowstorm” appearance of the left atrium indicating the presence of a right‐to‐left shunt. Right: ICE from case 1 shows intact septum following NobleStitch™ EL placement. Negative bubble study performed at the time of this image showed complete resolution of left‐to‐right shunt
FIGURE 3
FIGURE 3
Fluoroscopy during cardiac catheterization shows NobleStitch™ EL needle deployment and blind‐ending tunnel following KwiKnot deployment. Left: Fluoroscopy during case shows needle of the NobleStitch™ EL system capturing the septum secundum. Right: After KwiKnot deployment, contrast‐enhanced fluoroscopy shows blind‐ending tunnel with complete closure
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