Document Detail


Percutaneous transcatheter closure of patent foramen ovale in patients with paradoxical embolism.
MedLine Citation:
PMID:  12196339     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Percutaneous transcatheter closure of patent foramen ovale (PFO) is used as an alternative to surgery or long-term anticoagulation for the treatment of patients with paradoxical embolism and PFO. METHODS AND RESULTS: We report the immediate and long-term clinical and echocardiographic outcome of 110 consecutive patients (58 males, mean age 47+/-14 years) who underwent transcatheter closure of PFO because of paradoxical embolism between 1995 and 2001. Procedural success, defined as successful deployment of the device and effective occlusion (no, or trivial, shunt after device placement), was achieved in all (100%) patients. There was no in-hospital mortality, 1 device migration requiring surgical intervention (0.9%), and 1 episode of cardiac tamponade (0.9%) requiring pericardiocentesis. A progressive increment in full occlusion was observed (44%, 51%, 66%, and 71% at 1 day, 6 months, and 1 and 2 years, respectively, after device placement). At a mean follow-up of 2.3 years, 2 patients experienced recurrent neurological events (1 fatal stroke and 1 transient ischemic attack), representing an annual risk of recurrence of 0.9%. In addition, 4 (3.6%) of the patients required reintervention for device malalignment or significant shunt. Kaplan-Meier analysis showed a freedom from recurrent embolic events and reintervention of 96% and 90% at 1 and 5 years, respectively. CONCLUSIONS: Transcatheter closure of PFO is a safe and effective therapy for patients with paradoxical embolism and PFO. It is associated with a high success rate, low incidence of hospital complications, and low frequency of recurrent systemic embolic events.
Authors:
Francisco Martín; Pedro L Sánchez; Elizabeth Doherty; Pedro J Colon-Hernandez; Gabriel Delgado; Ignacio Inglessis; Nandita Scott; Judy Hung; Mary Etta E King; Ferdinando Buonanno; Zareh Demirjian; Michael de Moor; Igor F Palacios
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  106     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-27     Completed Date:  2002-09-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1121-6     Citation Subset:  AIM; IM    
Affiliation:
Cardiac Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
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MeSH Terms
Descriptor/Qualifier:
Cardiac Surgical Procedures* / adverse effects
Cardiac Tamponade / etiology,  surgery
Embolism, Paradoxical / etiology,  prevention & control*
Female
Follow-Up Studies
Foreign-Body Migration / etiology
Heart Catheterization / adverse effects,  instrumentation,  methods*
Heart Septal Defects, Atrial / complications,  surgery*
Humans
Male
Middle Aged
Prostheses and Implants / adverse effects
Recurrence / prevention & control
Risk Assessment
Surgical Procedures, Minimally Invasive / adverse effects
Treatment Outcome
Comments/Corrections
Comment In:
Circulation. 2002 Aug 27;106(9):1034-6   [PMID:  12196323 ]

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


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