Document Detail


Outcomes after transcatheter closure of patent foramen ovale in patients with paradoxical embolism.
MedLine Citation:
PMID:  17478164     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of the present study was to assess clinical outcomes and closure status after the transcatheter closure of patent foramen ovale. Two hundred thirty-seven consecutive patients (mean age 53 +/- 15 years; 48% men) who underwent patent foramen ovale closure for the prevention of recurrent stroke were evaluated. Primary end points were death, recurrent stroke, and residual right-to-left shunt (RLS). Closure status was monitored at 1, 6, 12, 24, 36, and 48 months after the index procedure by power M-mode transcranial Doppler and was defined by the number of embolic tracks detected after the release of a sustained, calibrated Valsalva maneuver. During a mean follow-up period of 568 +/- 364 days, the cumulative event rate for recurrent stroke (n = 8) was 3.4%, for an estimated event-free survival of 0.94 (SE 0.03). There was a significant difference in the estimated probability of recurrent stroke for patients grouped by age (< or =55 years 1.4% vs >55 years 6.6%, p = 0.03). There were 7 deaths (3.0%), 1 secondary to and 6 unrelated to recurrent strokes, and 3 surgical explantations (1.3%). Event-free survival, defined as freedom from death, stroke, or explantation, was 0.92 (SE 0.02). The magnitude of RLS was significantly less at late follow-up compared with baseline (grade 4.6 +/- 0.7 vs 1.8 +/- 1.6, p <0.001). Complete closure or minimal residual RLS (grade 0 to II) was achieved in 66% of patients. Device type (CardioSEAL or Amplatzer) did not affect the risk for adverse events or the presence of large residual RLS. In conclusion, transcatheter patent foramen ovale closure is associated with a low recurrent stroke rate in long-term follow-up.
Authors:
Verna Harms; Mark Reisman; Cindy J Fuller; Merrill P Spencer; John V Olsen; Kimberly A Krabill; William A Gray; Jill T Jesurum
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Publication Detail:
Type:  Journal Article     Date:  2007-03-19
Journal Detail:
Title:  The American journal of cardiology     Volume:  99     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-04     Completed Date:  2007-06-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1312-5     Citation Subset:  AIM; IM    
Affiliation:
Cardiovascular Research, Swedish Medical Center, Seattle, Washington; Seattle University, Seattle, Washington, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Balloon Occlusion*
Disease-Free Survival
Embolism, Paradoxical / etiology,  prevention & control*
Female
Follow-Up Studies
Heart Catheterization*
Heart Septal Defects, Atrial / complications,  therapy*
Humans
Intracranial Embolism / etiology,  prevention & control*
Male
Middle Aged
Recurrence / prevention & control
Retrospective Studies
Stroke / etiology,  prevention & control*
Treatment Outcome

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


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