Document Detail

Long-term outcome of transcatheter patent foramen ovale closure in patients with paradoxical embolism.
MedLine Citation:
PMID:  19178959     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Optimal management of patients with PFO and paradoxical embolic events is still debated. Moreover, data from long-term studies on large patient populations are lacking. Aim of the study is to assess immediate and long-term clinical outcome of patients with PFO and paradoxical thrombo-embolic events submitted to transcatheter PFO closure. METHODS: Only patients with PFO-related transient ischemic attack or stroke underwent PFO closure. Patients were evaluated clinically and echocardiographically at 1, 6 and 12 months after the procedure and yearly thereafter. Primary endpoints were death, recurrent stroke or TIA. Residual right-to left shunt (RLS) was monitored by transthoracic echocardiography (TTE) or transcranial Doppler (TCD) at 6 months'follow-up. RESULTS: 202 consecutive patients underwent percutaneous PFO closure for secondary prevention of TE. Device migration was observed in one patient 24 h after the procedure. No cases of procedure-related death or stroke occurred during a median follow-up of 3+/-1.3 years. Three recurrent TIAs were observed within the first 6 months of follow-up. The cumulative estimated probability of recurrent TE-free survival rate after PFO closure was 99% in patients <or=55 years, 84% in patients >55 years (p<0.05) and 94% and 100% in patients with PFO, with or without atrial septal aneurysm (ASA), respectively (p<0.05). Of the 188 (93%) patients submitted to TTE or TCD at 6 months' follow-up, 8 (4%) presented a small RLS. CONCLUSION: Transcatheter PFO closure is associated with low incidence of in-hospital complications and low frequency of recurrent TE at long-term follow-up.
Alberta Cifarelli; Carmine Musto; Antonio Parma; Claudia Pandolfi; Edoardo Pucci; Rosario Fiorilli; Francesco De Felice; Marco Stefano Nazzaro; Roberto Violini
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Publication Detail:
Type:  Journal Article     Date:  2009-01-29
Journal Detail:
Title:  International journal of cardiology     Volume:  141     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-31     Completed Date:  2010-09-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  304-10     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2008 Elsevier Ireland Ltd. All rights reserved.
Interventional Cardiology Unit, S Camillo/Forlanini Hospital, Circonvallazione Gianicolense 87, 00151 Rome, Italy.
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MeSH Terms
Cohort Studies
Embolism, Paradoxical / mortality*,  surgery*
Follow-Up Studies
Foramen Ovale, Patent / mortality*,  surgery*
Heart Catheterization*
Heart Septal Defects, Atrial / mortality,  surgery
Ischemic Attack, Transient / mortality
Middle Aged
Risk Factors
Septal Occluder Device*
Stroke / mortality
Treatment Outcome
Young Adult

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