Echocardiographic findings in simple and complex patent foramen ovale before and after transcatheter closure

Vitarelli, Antonio; Madon, E; Capotosto, Lidia; Tanzilli, Gaetano; D'Angeli, Ilaria; Toni, Danilo; Azzano, Alessia; Ricci, Serafino; Placanica, Attilio; Rinaldi, Ennio; Mukred, Khaled; Placanica, Giuseppe; Ashurov, Rasul

doi:10.1093/ehjci/jeu143

Cited by 40 publications

(46 citation statements)

References 38 publications

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“…Meissner et al reported the risk of paradoxical embolism was several times higher in patients with ASA regardless of a diagnosis of PFO . Furthermore, the presence of ASA has been associated with lower rates of successful closure and higher residual shunting at follow‐up, which was attributed to probable relative instability of the PFO device . However, due to its low prevalence in CS patients, the usefulness of ASA as a marker for selecting high risk patient that might benefit from PFO closure is undetermined.…”

Section: Discussionmentioning

confidence: 99%

“…20 Furthermore, the presence of ASA has been associated with lower rates of successful closure and higher residual shunting at follow-up, which was attributed to probable relative instability of the PFO device. 21 However, due to its low prevalence in CS patients, the usefulness of ASA as a marker for selecting high risk patient that might benefit from PFO closure is undetermined. In our 158 study subjects, the prevalence of ASA was only 7.6%…”

Section: Optimal Patient Selection For Pfo Closurementioning

confidence: 99%

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Effect of patent foramen ovale closure for prevention on recurrent stroke or transient ischemic attack in selected patients with cryptogenic stroke

Kim

Kim²,

Moon

et al. 2017

J Interven Cardiology

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Baseline characteristics were similar between the two groups, except age which was younger in the closure group (47.7 ± 10.8 vs 51.9 ± 9.9, P = 0.013), and the presence of shunt at rest was more common in the closure group (35.8% vs 10.4%, P = 0.000). Procedural success was 94.0%. Over a mean follow-up of 27.8 months, a total of six primary end point, all of which were strokes, occurred only in the medication group (6.6% vs 0%, P = 0.039). Stroke-free survival rate was significantly higher in the closure group (P = 0.026) CONCLUSIONS: Our study showed that PFO closure may be an effective treatment strategy to prevent recurrent stroke or TIA for patients with CS if it is conducted in selective patients who have PFO shunt more than moderate grade.

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Section: Discussionmentioning

confidence: 99%

Section: Optimal Patient Selection For Pfo Closurementioning

confidence: 99%

Effect of patent foramen ovale closure for prevention on recurrent stroke or transient ischemic attack in selected patients with cryptogenic stroke

Kim

Kim²,

Moon

et al. 2017

J Interven Cardiology

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“…Few studies on PFO closure were performed using the Occlutech Figulla ® devices, and to our knowledge no reports on the third generation Figulla ® Flex II PFO Occluder are available [15, 18–20, 22–24]. …”

Section: Discussionmentioning

confidence: 99%

Mid-term results of interventional closure of patent foramen ovale with the Occlutech Figulla® Flex II Occluder

Neuser

Akin

Bavendiek

et al. 2016

BMC Cardiovasc Disord

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BackgroundPatients with a patent foramen ovale (PFO) who suffered from stroke, TIA or peripheral paradoxical embolism are at substantial risk for recurrent neurologic events and in need for secondary prevention. Interventional closure of PFO has been performed for over 20 years. Numerous devices have been developed and used for treatment. We investigated PFO closure with the third generation Occlutech Figulla® Flex II Occluder device.MethodsBetween 2012 and 2015 57 patients (mean age 47.3 ± 1.5 years) who had suffered from a thromboembolic event of unknown cause underwent transcatheter PFO closure with the Occlutech Figulla® Flex II Occluder at our department. 68.4 % of all patients had suffered from cryptogenic stroke, while TIA had occurred in 28.1 %. Almost all patients were diagnosed with an atrial septum aneurysm (90.9 %) and a severe right-to-left shunt grade 3: >20 microbubbles (92.0 %). Follow-up was done 6 months post intervention by clinical examination and transesophageal contrast echocardiography.ResultsNo major periprocedural or in-hospital complication occurred. Closure was sufficient with no residual right-to-left shunt in 94.4 % of all patients at 6 months post implantation and only minimal residual shunt in three cases. There were no thrombotic formations associated to the occluder device. Atrial fibrillation occurred in one patient and a recurrent cerebral ischemic event was seen in one patient, who suffered from another TIA.ConclusionsThe Occlutech Figulla® Flex II Occluder device and its delivery system is safe and provides sufficient closure of PFO in patients who suffered from cryptogenic stroke, TIA or paradoxical peripheral embolism.

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“…The foramen ovale, on the right side of the septum, is entirely covered by its valve that pertains to the left atrial wall. Vitarelli et al recently published findings in patients with simple and complex patent foramen ovale before and after transcatheter closure . They found that a number of anatomic atrial variations, besides atrial septal aneurysm, impact percutaneous patent foramen ovale closure.…”

Section: Right Atrial Anatomymentioning

confidence: 99%

“…Vitarelli et al recently published findings in patients with simple and complex patent foramen ovale before and after transcatheter closure. 18 They found that a number of anatomic atrial variations, besides atrial septal aneurysm, impact percutaneous patent foramen ovale closure. In addition, they revealed that success of the occlusion, determined by the absence of residual shunting on contrast twodimensional TEE, was significantly associated with the morphologic features of the atrial septum.…”

Section: Introductionmentioning

confidence: 99%

The right atrium, a forgotten cardiac chamber: An updated review of multimodality imaging

Tadić

2015

J. Clin. Ultrasound

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Despite several limitations, two-dimensional echocardiography (2DE) is the standard method for assessing the right atrium (RA) in everyday clinical routine. Cardiac magnetic resonance remains the current "gold standard" for RA visualization and volume quantification. The development of 2DE-derived strain imaging has enabled assessing RA deformation and phasic function in various pathologic conditions. Three-dimensional echocardiography was demonstrated to be more accurate and reproducible than 2DE for cardiac chamber quantification, while also allowing the evaluation of RA phasic function without geometric assumption. The purpose of this review is to summarize currently available data about RA anatomy, phasic function, and mechanics acquired by different imaging modalities.

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Echocardiographic findings in simple and complex patent foramen ovale before and after transcatheter closure

Abstract: In our series of patients, the closure rate was dependent on PFO morphology more than occluder size and type. An adjunctive device was implanted in selected cases.

Cited by 40 publications

References 38 publications

Effect of patent foramen ovale closure for prevention on recurrent stroke or transient ischemic attack in selected patients with cryptogenic stroke

Effect of patent foramen ovale closure for prevention on recurrent stroke or transient ischemic attack in selected patients with cryptogenic stroke

Mid-term results of interventional closure of patent foramen ovale with the Occlutech Figulla® Flex II Occluder

The right atrium, a forgotten cardiac chamber: An updated review of multimodality imaging

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