Document Detail


Recurrent events after percutaneous closure of patent foramen ovale.
MedLine Citation:
PMID:  22707325     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To determine the incidence of symptomatic recurrent embolic events after PFO closure and potential causes for these events. BACKGROUND: It is well known that cerebral or other embolic events may occur after patent foramen ovale (PFO) closure. METHODS: This is a retrospective analysis of consecutive patients who underwent PFO closure for secondary prevention of embolic events at a single institution. RESULTS: 1930 patients (mean age of 50 ± 13.3 years) underwent transcatheter PFO closure. Complete closure occurred in 92%. The annual recurrence rate of embolic events before PFO closure was 22.4% (785 events in 3497 patient-years). During follow-up (mean 39 months) 63 recurrent events were documented: 25 strokes, 36 transient ischemic attacks (TIA) and 2 peripheral embolic events. The overall annual recurrence rate after the procedure was 1.3% per year (63 events in 6211 patient-years). The majority of events occurred in patients without residual shunts (54/63). There was no significant association between the presence of a residual shunt and recurrent events (HR 1.7; 95% CI 0.8-3.6, p=0.16). The most common cause for recurrent events was atherosclerosis. Nine out of 63 events were considered likely or possible paradoxical embolism due to residual shunt (stroke (2), TIA (5), peripheral embolism (2)). After PFO closure, the annual rate of events potentially related to paradoxical embolism was 0.14% (9 events in 6211 patient- years). CONCLUSION: The incidence of symptomatic embolic events after PFO closure is low. Most recurrent events are related to coexistent conditions associated with thromboembolic risk rather than residual shunts. © 2012 Wiley Periodicals, Inc.
Authors:
Julia Wallenborn; Stefan C Bertog; Jennifer Franke; Daniel H Steinberg; Nicolas Majunke; Neil Wilson; Nina Wunderlich; Horst Sievert
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-18
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Affiliation:
CardioVascular Center Frankfurt, Frankfurt am Main, Germany.
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