Document Detail


Incomplete aneurysm coverage after patent foramen ovale closure in patients with huge atrial septal aneurysm: effects on left atrial functional remodeling.
MedLine Citation:
PMID:  20718907     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Large devices are often implanted to treat patent foramen ovale (PFO) and atrial septal aneurysm (ASA) with increase risk of erosion and thrombosis. Our study is aimed to assess the impact on left atrium functional remodeling and clinical outcomes of partial coverage of the approach using moderately small Amplatzer ASD Cribriform Occluder in patients with large PFO and ASA.
METHODS: We prospectively enrolled 30 consecutive patients with previous stroke (mean age 36 +/- 9.5 years, 19 females), significant PFO, and large ASA referred to our center for catheter-based PFO closure. Left atrium (LA) passive and active emptying, LA conduit function, and LA ejection fraction were computed before and after 6 months from the procedure by echocardiography. The preclosure values were compared to values of a normal healthy population of sex and heart rate matched 30 patients.
RESULTS: Preclosure values demonstrated significantly greater reservoir function as well as passive and active emptying, with significantly reduced conduit function and LA ejection fraction, when compared normal healthy subjects. All patients underwent successful transcatheter closure (25 mm device in 15 patients, 30 mm device in 6 patients, mean ratio device/diameter of the interatrial septum = 0.74). Incomplete ASA coverage in both orthogonal views was observed in 21 patients. Compared to patients with complete coverage, there were no differences in LA functional parameters and occlusion rates.
CONCLUSIONS: This study confirmed that large ASAs are associated with LA dysfunction. The use of relatively small Amplatzer ASD Cribriform Occluder devices is probably effective enough to promote functional remodeling of the left atrium.
Authors:
Gianluca Rigatelli; Federico Ronco; Paolo Cardaioli; Fabio Dell'avvocata; Gabriele Braggion; Massimo Giordan; Silvio Aggio
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of interventional cardiology     Volume:  23     ISSN:  1540-8183     ISO Abbreviation:  J Interv Cardiol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-19     Completed Date:  2010-12-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8907826     Medline TA:  J Interv Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  362-7     Citation Subset:  IM    
Affiliation:
Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy. jackyheart@libero.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Atrial Function, Left / physiology*
Case-Control Studies
Echocardiography, Transesophageal
Female
Foramen Ovale, Patent / physiopathology,  surgery*
Heart Aneurysm / physiopathology,  surgery*,  ultrasonography
Heart Atria / physiopathology,  ultrasonography
Humans
Male
Prospective Studies
Septal Occluder Device
Stroke Volume

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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