Document Detail

Patent oval foramen transcatheter closure: results of a strategy based on tailoring the device to the specific patient's anatomy.
MedLine Citation:
PMID:  20219151     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Usually the literature results for device-closure of patent oval foramen concern a single type of device or different devices implanted without anatomical preferences. We propose a strategy of device type and selection based on intra-cardiac echocardiography measurements of inter-atrial septum characteristics. METHODS: We prospectively enrolled 100 consecutive patients with a mean age of 43 plus or minus 15.5 years, 68 females, who had been referred to our centre for catheter-based closure of inter-atrial shunts over a 48-month period. On the basis of intra-cardiac echocardiography findings the operators selected the Amplatzer Occluder family (AGA Medical Corporation) or the Premere Closure System (St Jude Medical Inc.). Determinants of the selection process were presence and extension of atrial septal aneurysm, tunnel length, rims length, and thickness, presence of additional fenestrations. RESULTS: According on intra-cardiac echocardiography study, 26 patients have a long channel patent oval foramen, 44 patients had a large atrial septal aneurysm (more than four RL), 24 patients had a moderate atrial septal aneurysm (more than two RL but less than four right-to-left), and six patients had hypertrophic rims. Thus, the Amplatzer PFO Occluder was selected in 24 patients, the Amplatzer ASD Cribriform Occluder in 44 patients, and the Premere device in 32 cases. No aortic erosions, device thrombosis, or recurrent ischaemic cerebral events were observed. Pre-discharge and follow-up occlusion rates were 91% and 96%, respectively. CONCLUSIONS: Our study suggested that such strategy driven from identification and measurements of the right atrium and inter-atrial septum components resulted in low complications and high-success rates, mandatory conditions when facing with otherwise healthy subjects, such as the patients with patent oval foramen.
Gianluca Rigatelli; Fabio Dell'Avvocata; Federico Ronco; Massimo Giordan; Paolo Cardaioli
Publication Detail:
Type:  Journal Article     Date:  2010-03-11
Journal Detail:
Title:  Cardiology in the young     Volume:  20     ISSN:  1467-1107     ISO Abbreviation:  Cardiol Young     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-19     Completed Date:  2010-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200019     Medline TA:  Cardiol Young     Country:  England    
Other Details:
Languages:  eng     Pagination:  144-9     Citation Subset:  IM    
Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Via WA Mozart 9, Legnago, Verona, Italy.
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MeSH Terms
Atrial Septum / ultrasonography
Foramen Ovale, Patent / therapy*,  ultrasonography
Middle Aged
Prospective Studies
Prosthesis Design
Prosthesis Fitting
Prosthesis Implantation
Septal Occluder Device*
Young Adult

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