title: Transthoracic echocardiography guidance during percutaneous closure of patent foramen ovale.
abstract: BACKGROUND
  Percutaneous closure of patent foramen ovale (PFO) has been increasingly performed for several indications; mostly due to cryptogenic stroke. In this study we aimed to evaluate the safety and efficacy of transthoracic echocardiographic (TTE) guidance during percutaneous closure of PFO in using the Amplatzer and Occlutech Figulla PFO occluder devices.
  
  
  METHODS
  Between October 2005 and March 2011, 139 patients (74 male, mean age: 40.4 ± 10.3) underwent transcatheter PFO closure. In all patients transesophageal echocardiography performed subsequently to diagnose, assess the size and evaluate for suitability of the defect for percutaneous closure. During the procedure fluoroscopy and TTE were used for guidance.
  
  
  RESULTS
  Among 139 patients, Amplatzer PFO occluder was used in 74 patients and in 65 of them Occlutech Figulla device was selected for occlusion. The indications for PFO closure were ischemic stroke in 98 (70.5%), recurrent transient ischemic attacks (TIA) in 40 (28.7%), peripheral embolism in 1 (0.8%) of the patients. In all patients, percutaneous intervention was performed successfully under TTE guidance. There have been no neurologic (recurrent strokes or TIAs) and cardiovascular complications during the immediate and long-term follow-up period (2-67 months, median 29). There was significant difference between the mean fluoroscopic time from the beginning which is 8.6 ± 3.4 min in the former versus 3.4 ± 1.9 min in the latter (P < 0.05).
  
  
  CONCLUSIONS
  Our study confirms the efficacy and safety of TTE guidance during percutaneous closure of PFO, which shortens the procedural time and obviates the need for general anesthesia or endotracheal intubation.
authors.affiliation: Department of Cardiology, Hacettepe University, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Oto
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.forename: Süheyla
authors.initials: S
authors.lastname: Ozkutlu
authors.forename: Ergün Barış
authors.initials: EB
authors.lastname: Kaya
authors.forename: Hikmet
authors.initials: H
authors.lastname: Yorgun
authors.forename: Uğur
authors.initials: U
authors.lastname: Canpolat
authors.forename: Ahmet Hakan
authors.initials: AH
authors.lastname: Ateş
authors.forename: Hilmi
authors.initials: H
authors.lastname: Ozkutlu
mesh_terms: D000328:Adult; D004452:Echocardiography / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D054092:Foramen Ovale, Patent / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D055989:Septal Occluder Device / Q000706:statistics & numerical data*; D025321:Surgery, Computer-Assisted / Q000379:methods / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology