Morphological features pertinent to interventional closure of patent oval foramen.
Despite the growing trend of device closure for patent ovale foramens (PFO), the morphology of these lesions is much neglected. A better understanding of the morphological aspects is needed for developing lesion-specific devices. We reviewed ten heart specimens and distinguished two forms of PFO: valve competent and valve incompetent. In the valve-competent form, the thin valve of the oval foramen adequately overlaps the firmer muscular rim of the foramen, leaving a crevice-like aperture sandwiched between the two structures. In contrast, the valve-incompetent form results from aneurysmal ballooning of the valve, or stretching of the muscular rim, creating an interatrial communication in a previously competent flap valve. Distinguishing between the two forms can help in designing and selecting the most appropriate device for implantation.
Ho
Siew Yen
SY
National Heart and Lung Institute, Imperial College, Royal Brompton and Harefield Hospital, NHS Trust, London, United Kingdom. yen.ho@imperial.ac.uk
McCarthy
Karen P
KP
Rigby
Michael L
ML
D001022:Aortic Valve Insufficiency / Q000473:pathology / Q000601:surgery; D006348:Cardiac Surgical Procedures; D006322:Heart Aneurysm / Q000473:pathology / Q000601:surgery; D006344:Heart Septal Defects, Atrial / Q000473:pathology* / Q000601:surgery*; D006351:Heart Valves / Q000601:surgery; D006801:Humans; D008955:Models, Cardiovascular; D014654:Vascular Patency / Q000502:physiology