Document Detail


Percutaneous patent foramen ovale closure: outcomes with the Premere and Amplatzer devices.
MedLine Citation:
PMID:  21640934     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Transcatheter closure of patent foramen ovale (PFO) has rapidly evolved as the preferred management strategy for the prevention of recurrent cerebrovascular events in patients with cryptogenic stroke and presumed paradoxical embolus. There is limited outcome data in patients treated with this therapy particularly for the newer devices.
METHODS: Data from medical records, catheter, and echocardiography databases on 70 PFO procedures performed was collected prospectively.
RESULTS: The cohort consisted of 70 patients (mean age 43.6 years, range 19 to 77 years), of whom 51% were male. The indications for closure were cryptogenic cerebrovascular accident (CVA) or transient ischemic attack (TIA) in 64 (91%) and peripheral emboli in two (2.8%) patients and cryptogenic ST-elevation myocardial infarction in one (1.4%), refractory migraine in one (1.4%), decompression sickness in one (1.4%), and orthodeoxia in one (1.4%) patient, respectively. All patients had demonstrated right-to-left shunting on bubble study. The procedures were guided by intracardiac echocardiography in 53%, transesophageal echocardiography in 39%, and the remainder by transthoracic echo alone. Devices used were the Amplatzer PFO Occluder (AGA Medical) (sizes 18-35 mm) in 49 (70%) and the Premere device (St. Jude Medical) in 21 (30%). In-hospital complications consisted of one significant groin hematoma with skin infection. Echocardiographic follow-up at 6 months revealed that most patients had no or trivial residual shunt (98.6%), while one patient (1.4%) had a mild residual shunt. At a median of 11 months' follow-up (range 1 month to 4.3 years), no patients (0%) experienced further CVA/TIAs or paradoxical embolic events during follow-up.
CONCLUSION: PFO causing presumed paradoxical embolism can be closed percutaneously with a low rate of significant residual shunting and very few complications. Recurrent index events are uncommon at medium-term (up to 4 years) follow-up.
Authors:
Naylin Bissessor; Allison W Wong; Lisa A Hourigan; Rohan S Jayasinghe; Greg S Scalia; Darryl J Burstow; Lyn R Griffiths; Michael Savage; Darren L Walters
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Publication Detail:
Type:  Journal Article     Date:  2010-10-20
Journal Detail:
Title:  Cardiovascular revascularization medicine : including molecular interventions     Volume:  12     ISSN:  1878-0938     ISO Abbreviation:  Cardiovasc Revasc Med     Publication Date:    2011 May-Jun
Date Detail:
Created Date:  2011-06-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101238551     Medline TA:  Cardiovasc Revasc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  164-9     Citation Subset:  IM    
Copyright Information:
Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.
Affiliation:
The Prince Charles Hospital, Chermside, Brisbane, Queensland, Australia; Gold Coast Hospital, Queensland, Australia; Genomics Research Centre, Griffith Institute Medical Research, Griffith University, Southport, Queensland, Australia; University of California, Los Angeles, Los Angeles, CA, USA.
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