Percutaneous patent foramen ovale occlusion: Current evidence and evolving clinical practice

Leong, Ming Chern; Uebing, Anselm

doi:10.1016/j.ijcard.2013.08.095

Cited by 16 publications

(6 citation statements)

References 54 publications

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“…Patent foramen ovale (PFO) is a small interatrial shunt caused by incomplete apposition of the septum primum to the septum secundum. Catheter closure is usually performed on carefully selected patients, as we need more data from randomized clinical trials comparing oral anticoagulants, antiplatelet therapy, and catheter occlusion .…”

Section: Introductionmentioning

confidence: 99%

Infective endocarditis after device closure of atrial septal defects: Case report and review of the literature

Amedro

Soulatges

Fraisse

2016

Cathet Cardio Intervent

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We report a case of late infective endocarditis in an 8-year-old boy 3 years after transcatheter closure of an atrial septal defect with the Amplatzer Atrial Septal Occluder Device. Echocardiography showed a very thick pannus lining the left atrial disc of the prosthesis, with some mobile elements. MRI showed several cerebral microemboli. The patient had dental caries and blood cultures found Staphylococcus aureus. Patient was treated with gentamicin and oxacillin before surgical removal of the prosthesis. Twenty-one cases of infective endocarditis after atrial defect device closure have been reported in the literature (13 ostium secundum ASD and 8 patent foramen ovale). Seven pediatric cases were reported. S. aureus was the most frequent bacterium. Antibiotics were administered in all cases and most patients (n = 18) underwent surgical removal of the device. Incomplete endothelialization of the prosthesis was a suggested mechanism. Two patients died after surgery. © 2016 Wiley Periodicals, Inc.

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Section: Introductionmentioning

confidence: 99%

Infective endocarditis after device closure of atrial septal defects: Case report and review of the literature

Amedro

Soulatges

Fraisse

2016

Cathet Cardio Intervent

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“…6,12 Venous thromboses are further hazardous complications in ACHD as paradoxical emboli may reach the arterial circulation if a shunt is present. 13,14 At particular risk are ACHD with pulmonary arterial hypertension, Eisenmenger syndrome, tricuspid stenosis, or Ebstein's anomaly. In our study, the most common shunt lesions were ASD and PFO.…”

mentioning

confidence: 99%

Usefulness of Direct Oral Anticoagulants in Adult Congenital Heart Disease

Pujol

Niesert

Engelhardt

et al. 2016

The American Journal of Cardiology

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As thromboembolic events (TEE) are common in adults with congenital heart disease (ACHD), adequate oral anticoagulation for prophylaxis or treatment of TEE is important. Until now, mainly vitamin K antagonists have been used in these patients. The purpose of this study was to provide first data on the use of direct oral anticoagulants in ACHD. This prospective, observational, and longitudinal study included 102 consecutive ACHD, of whom 75 (37 women and 38 men; mean age 50 ± 13 years) could be analyzed. Most common CHD were pre-tricuspid shunts (n = 31; 41%), complex CHD (n = 16; 21%), left heart/aortic valve anomalies (n = 5; 6%), right-sided cardiac/pulmonary artery anomalies (n = 9; 13%), post-tricuspid shunts (n = 3; 4%), and others (n = 11; 15%). Five patients had cyanosis and 3 patients a Fontan circulation. Mean follow-up was 12 ± 11 months. Rivaroxaban was administered in 55 patients, apixaban in 13 and dabigatran in 7 patients for TEE prophylaxis in atrial arrhythmias (n = 57), stroke/transient ischemic attacks (n = 11), deep vein thrombosis (n = 4), pulmonary embolism (n = 1) and atrial thrombi (n = 3). Some patients had >1 indication for adequate oral anticoagulation. CHA2-DS2-VASc score was ≥ 2 in 23 (31%), and 9 (12%) had a HAS-BLED score ≥ 2. There were neither thrombotic or major bleeding events nor major side effects. In conclusion, direct oral anticoagulants appear to be safe and effective in ACHD. Long-term follow-up is needed to substantiate these findings.

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“…The risk of cryptogenic stroke tends to exponentially increase in the presence of PFO (odds ratio [OR], 1.83; 95% confidence interval [CI], 1.25-2.66), ASA (OR, 2.35; 95% CI, 1.46-3.77), and combined PFO with ASA (OR, 4.96; 95% CI, 2.37-10.39). 13 Various mechanisms have been proposed for additional increased risk in cryptogenic stroke due to the presence of ASA with PFO: risk for thrombus formation due to turbulent flow across a PFO tunnel or perianeurysmal pockets or local flow stasis or via incomplete atrial emptying; 14 or hemodynamic allowance of paradoxical emboli via the PFO conduit. 15…”

Section: Atrial Septal Aneurysmmentioning

confidence: 99%

Patent Foramen Ovale: Risk Factors and Diagnostic Comparison of Transcranial Doppler versus Echocardiography for Secondary Stroke Prevention

Malhotra¹,

Katsanos²,

Frogoudak³

et al. 2019

J Neurosonol Neuroimag

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Various factors correlated to PFO that tend to increase its causal relationship with cryptogenic ischemic stroke include: young age, valsalva maneuver (VM), recent prolonged immobility, concomitant DVT in legs or pelvis, presence of atrial septal aneurysm (ASA), history of migraine with aura, and neuroimaging demonstrating solitary cortical or bilateral embolic pattern. 3 Few of these factors have been discussed in the following section.

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Percutaneous patent foramen ovale occlusion: Current evidence and evolving clinical practice

Cited by 16 publications

References 54 publications

Infective endocarditis after device closure of atrial septal defects: Case report and review of the literature

Infective endocarditis after device closure of atrial septal defects: Case report and review of the literature

Usefulness of Direct Oral Anticoagulants in Adult Congenital Heart Disease

Patent Foramen Ovale: Risk Factors and Diagnostic Comparison of Transcranial Doppler versus Echocardiography for Secondary Stroke Prevention

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