title: Patent foramen ovale using the Premere device: the results of the CLOSEUP trial.
abstract: OBJECTIVE
  The CLOSEUP trial was conducted to determine the safety and effectiveness of the Premere closure device in closure of patent foramen ovale (PFO).
  
  
  BACKGROUND
  PFO is a relatively common congenital condition, associated with cryptogenic stroke and migraine with aura. The Premere device is specifically designed to close PFO of variable size and length, with right and left anchor arms connected by a flexible tether. The device has an open architecture, a low profile, and a small surface area on the left atrial side which may discourage thrombus formation.
  
  
  METHODS
  Patients between 18 and 65 years of age who had a cryptogenic ischemic stroke or a transient ischemic attack and a PFO underwent percutaneous PFO closure using the Premere device.
  
  
  RESULTS
  Of the 73 enrolled patients, six patients had atrial anatomy not appropriate for the Premere; 27 patients received the 15 mm and 40 patients received the 20 mm device. Implantation was successful in all patients. At 6 months of follow-up, 86% of patients had no shunt that could be provoked with Valsalva as assessed during contrast echocardiography. Closure rates were better with the 20 mm versus the 15 mm device, and three patients with residual shunt had atrial septal aneurysms at baseline. One patient had transient atrial fibrillation which resolved by 3 months. There were no instances of thrombus, death, or stroke.
  
  
  CONCLUSIONS
  These data demonstrate that the Premere device can safely and effectively close PFO. Additional studies should be undertaken to demonstrate the effectiveness of PFO closure in reducing thrombo-embolic events such as stroke.
authors.affiliation: CardioVascular Center, Sankt Katharinen, Frankfurt, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Büscheck
authors.forename: Horst
authors.initials: H
authors.lastname: Sievert
authors.forename: Franz
authors.initials: F
authors.lastname: Kleber
authors.forename: Christiane
authors.initials: C
authors.lastname: Tiefenbacher
authors.forename: Urilke
authors.initials: U
authors.lastname: Krumsdorf
authors.forename: Stephen
authors.initials: S
authors.lastname: Windecker
authors.forename: Frank
authors.initials: F
authors.lastname: Uhlemann
authors.forename: Dennis W
authors.initials: DW
authors.lastname: Wahr
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000295:instrumentation*; D004452:Echocardiography; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D011474:Prosthesis Design; D016896:Treatment Outcome