Percutaneous patent foramen ovale and atrial septal defect closure in adults: Results and device comparison in 100 consecutive implants at a single center

Abstract

Closure of interatrial septal defects with percutaneous devices is increasingly common. However, the indications for closure and techniques for device implantation are diverse. We reviewed our first 100 consecutive implants to assess and compare the indications, results, complications, and evolution of techniques for percutaneous patent foramen ovale (PFO) and atrial septal defect (ASD) closure. The mean age of patients was 52 years and 70% were female. Paradoxical embolism was the predominant indication (94%) for PFO closure and significant left-to-right shunt was the most frequent indication (89%) for ASD closure. Implantation success was 94% with major complications in 3 patients (2.8%). Transesophageal echocardiography was utilized in the initial 27 procedures and then replaced by intracardiac echocardiography in subsequent ones, with an associated reduction in procedure and physician time. During 6 months of follow-up, 3 patients were readmitted for atrial arrhythmias (2 patients) and an MRI-negative neurologic event (1 patient). Echocardiography at 6 months in 83% of the PFO patients revealed moderate and severe positive contrast studies for right-to-left shunting in one third of patients, with differences between devices and insertion techniques. This single-center experience with percutaneous device closure of PFO and ASD in adults demonstrates excellent results with few complications.

Efetividade da prótese de Amplatzer™ para fechamento percutâneo do defeito do septo interatrial tipo Ostium Secundum

“…Immediate and late complications are shown in Table 3. the Amplatzer ® device is very safe and effective. From the 101 patients included in the study, there were no deaths, cardiac perforations or other serious complications during the hospital phase, which is consistent with the reports in literature 19,20 . During the late evolution, currently at 12.81 ± 8.41 months, no cases of thrombi, embolization or endocarditis related to the device have been recorded even though these complications have been reported in literature [21][22][23] .…”

A propensity score-matched comparison between Cardia and Amplatzer PFO closure devices - insights from the SOLUTION registry (Swiss percutaneOus patent foramen ovale cLosUre in recurrent clinical events prevenTION)

“…The latter calculated recurrent neurological events as 0.4-0.8 events per 100 person-years (95% CI: 0.5-1.1) for transcatheter closure versus 2.5-5.0 events per 100 person-years (95% CI: 3.6-6.9) for medical treatment. Considering the limited number of studies comparing the various PFO occluders [15][16][17][18][19][20] , we aimed to compare the clinical outcomes of patients after implantation of either the Amplatzer PFO occluder (APFO; St. Jude Medical, St. Paul, MN, USA) or the Cardia Intrasept occluder (CPFO; Cardia Inc., Eagan, MN, USA) in a large population of unselected consecutive patients.…”

Transcatheter Device Closure of Interatrial Septal Defects in Patients with Hypoxia

“…Percutaneous Intervention and Follow‐Up Patients underwent percutaneous closure using techniques as previously described 13 . In cases utilizing intracardiac echocardiography (ICE), an additional 11 French venous sheath was placed.…”