Closure of patent foramen ovale: when and how?
Percutaneous closure of a patent foramen ovale (PFO) was performed in 98 consecutive patients (mean age 52.5 +/- 13 years, 61 women). Indications included recurrent transient ischaemic attack (47%), cryptogenic stroke (34%), peripheral embolism (11%), disabling migraine with aura (4%), professional scuba diving (1 pt) and severe platypnea-orthodeoxia syndrome (1 pt). Each PFO was characterized by transesophageal echocardiography (TEE) according to anatomy, degree of shunt (1-mild, 2-moderate, 3-severe), right atrial anatomical features relevant for PFO closure (such as presence of an Eustachian valve, Chiari network, lipomatosis or absence of septum secundum) with a new classification scheme. According to this classification successful device delivery was obtained in 100% of pts. Major complications included heparin-induced thrombocytopenia in 1 pt and device dislodgment in 1 pt; minor complications were mostly related to the catheter introduction site (2 pts) and mild immediate shunt (2 pts). In conclusion, percutaneous PFO closure based on strict anatomic criteria is a safe procedure with minimal periprocedural complications.
Lisignoli
Veronica
V
Istituto Clinico Humanitas Mirasole Spa, Via Manzoni, Rozzano, Italy.
Lanzone
Alberto M
AM
Zavalloni
Dennis
D
Pagnotta
Paolo
P
Presbitero
Patrizia
P
D006328:Cardiac Catheterization / Q000009:adverse effects; D003665:Decompression Sickness / Q000150:complications; D004242:Diving; D004417:Dyspnea / Q000209:etiology; D017548:Echocardiography, Transesophageal; D004617:Embolism / Q000209:etiology / Q000517:prevention & control; D004868:Equipment Failure; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D002546:Ischemic Attack, Transient / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D020325:Migraine with Aura / Q000209:etiology; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D019736:Prostheses and Implants; D012008:Recurrence; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D013577:Syndrome; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors