Impact of Percutaneous Device Implantation for Closure of Patent Foramen Ovale on Valve Insufficiencies

Abstract

Background-In patients with percutaneous device implantation for closure of patent foramen ovale (PFO), a 10% incidence of new or worsened aortic regurgitation within 12 months has been reported with echocardiography. Cardiac magnetic resonance imaging is a powerful noninvasive tool to quantify volume and fraction of valve insufficiencies. We studied the acute and long-term impact of percutaneous device implantation for PFO closure on valve insufficiencies in cardiac magnetic resonance imaging. Methods and Results-Sequential cardiac magnetic resonance imaging studies were performed in 102 patients with cryptogenic ischemic events. Cardiac magnetic resonance imaging was performed before PFO closure, the day after device implantation, and at 12 months of follow-up. There was no difference in volumetric and hemodynamic parameters before PFO closure compared with 12 months of follow-up. With a cutoff for relevant regurgitation fraction of 5%, there were no statistically significant differences in regurgitation fraction of the semilunar and atrioventricular valves. The median fraction of aortic valve insufficiency was 3.9% (interquartile range [IQR] 2.0% to 5.1%) before PFO closure, 5.4% (IQR 4.1% to 5.9%) after device implantation, and 4.3% (IQR 3.3% to 6.0%) at 12 months of follow-up. The size and type of the occluder had no impact on aortic valve insufficiency. Median regurgitation fraction for the pulmonary valve was 3.6% (IQR 2.4% to 6.7%) before intervention, 7.3% (IQR 5.1% to 8.2%) after occluder implantation and 5.8% (IQR 4.8% to 7.4%) at 12 months of follow-up. Values for the mitral valve were 3.1% (IQR 1.4% to 6.0%), 5.5% (IQR 3.5% to 7.3%), and 3.8% (IQR 1.5% to 7.9%) and for the tricuspid valve were 5.4% (IQR 0.1% to 8.8%), 5.8% (IQR 1.4% to 9.2%), and 6.0% (IQR 1.1% to 8.4%), respectively. Conclusions-Percutaneous

Effect of percutaneous atrial septal defect and patent foramen ovale device closure on degree of aortic regurgitation

“…In another study, Wöhrle et al used cardiac magnetic resonance imaging (MRI) to examine the impact of PFO device closure on AR . They performed sequential MRI on 102 patients before and 12‐months following device closure, and concluded that percutaneous device closure of PFO had no impact on valve competency, including AR.…”

Does the amplatzer septal occluder device alter ventricular contraction pattern? A ventricular motion analysis by MR tagging

“…The ASO abolished the former left‐to‐right shunt at the atrial level, thus unloading the enlarged right atrium and right ventricle in this patient group. The median time interval between defect closure and MR study was 23 days (1–120). The inner diameters of the occluders ranged from 14 to 26 mm.…”

“…The bulky profile of the ASO and the need of atrial stretch and deformation raise concerns and led to the development of lower‐profile devices (5). A 10% rate of newly developed or worsened aortic regurgitation was observed after implantation of Amplatzer PFO occluders (6).…”

Prevalence of Myocardial Scar in Patients With Cryptogenic Cerebral Ischemic Events and Patent Foramen Ovale

“…All data were acquired utilizing a dedicated 5-element cardiac phased-array coil. To determine left and right ventricular function, a retrospective ECG-gated segmented k-space balanced turbo field-echo sequence (steady-state free-precession [SSFP]) was used in short-and long-axis views along the true heart axis (11). Depending on the required field of view, the spatial resolution was Wöhrle et al Myocardial Scar and Cryptogenic Stroke between 1.7 ϫ 1.8 mm and 2.3 ϫ 1.8 mm in-plane.…”