Document Detail


Predictors and clinical outcomes of residual shunt in patients undergoing percutaneous transcatheter closure of patent foramen ovale.
MedLine Citation:
PMID:  17090816     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine echocardiographic characteristics that may identify patients likely to have residual right-to-left shunt after percutaneous closure of a patent foramen ovale (PFO). BACKGROUND: Characteristics of the atrial septum and PFO may identify patients who are likely to have residual shunt following percutaneous closure. METHODS: We reviewed 76 consecutive patients (42 women; 34 men) who underwent percutaneous PFO closure (AGA Amplatzer PFO occluder) for hypoxemia or paradoxical embolization who failed or were unable to receive systemic anticoagulation. Saline contrast echocardiography with and without the Valsalva maneuver was performed within 24 hours and after 6 months to assess for residual shunt. RESULTS: 48 patients (63%) had early closure of the PFO with total elimination of the shunt. Residual shunt was detected in 28 patients (37%), although the severity had diminished significantly compared to baseline. All patients with atrial septal aneurysm (n = 7), and all but 1 patient with a redundant atrial septum (n = 6) before percutaneous closure had residual shunts (p < 0.001). The patient's age, device size and PFO dimensions did not predict procedural success. At 6-month follow up, residual shunt had resolved in all but 3 patients. One of these 3 patients had a recurrent nonfatal transient ischemic event. CONCLUSIONS: A percutaneous transcatheter approach confers early closure of PFO and elimination of the shunt in a majority of patients. Residual shunts are seen in patients with a redundant atrial septum and atrial septum aneurysm in the early post-closure period, but resolve without major clinical sequelae by 6 months.
Authors:
Alan Zajarias; Srihari Thanigaraj; John Lasala; Julio Perez
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  18     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-11-08     Completed Date:  2007-02-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  533-7     Citation Subset:  IM    
Affiliation:
Cardiovascular Division, Washington University School of Medicine, St Louis, Missouri 63110, USA. azajaria@im.wustl.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Balloon Occlusion / adverse effects*,  instrumentation,  methods*
Echocardiography, Transesophageal / methods*
Female
Follow-Up Studies
Heart Septal Defects, Atrial / therapy*,  ultrasonography*
Humans
Male
Middle Aged
Predictive Value of Tests
Probability
Retrospective Studies
Risk Assessment
Severity of Illness Index
Treatment Outcome
Comments/Corrections
Comment In:
J Invasive Cardiol. 2006 Nov;18(11):538-9   [PMID:  17090817 ]

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


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