Transcatheter Device Closure of Interatrial Septal Defects in Patients with Hypoxia

Abstract

Percutaneous closure of IASDs in a heterogeneous group of patients with hypoxia can be safely and effectively performed. The procedure results in immediate arterial saturation improvement and reduced right-to-left shunting.

Guidelines for the Echocardiographic Assessment of Atrial Septal Defect and Patent Foramen Ovale: From the American Society of Echocardiography and Society for Cardiac Angiography and Interventions

“…65,83,85,88,91,92,146,156 ICE offers imaging that is comparable to TEE and superior to TEE with respect to LA structures and the posterior-inferior rim of the septum. An additional 8F-11F sheath is required for the intracardiac echocardiographic system.…”

Resting arterial hypoxaemia in subjects with chronic heart failure, pulmonary hypertension and patent foramen ovale

“…Surgical closure of the PFO may be undertaken for various reasons, such as history of stroke or transient ischaemic attack, yet PFO closure for this purpose remains controversial. However, because PFO contributes to arterial hypoxaemia in subjects with CHF and pulmonary hypertension, these specific subjects may also benefit from PFO closure as an intervention to improve oxygenation, particularly in those subjects with more severe levels of hypoxaemia (Ilkhanoff et al 2005;Fenster et al 2013).…”

“…Blood flow though a patent foramen ovale (PFO;Q PFO ) is present in at least 30% of the general population (Woods et al 2010;Elliott et al 2013;Marriott et al 2013) and is known to reduce pulmonary gas exchange efficiency in healthy humans Elliott et al 2015) and patient populations (Ilkhanoff et al 2005;Fenster et al 2013). With increased right atrial pressures in subjects with CHF and pulmonary hypertension,Q PFO might be even greater than that in conditions of normal right atrial pressure, and thus,Q PFO could have an even greater potential to worsen pulmonary gas exchange efficiency in these subjects.…”

Pathophysiology of Congenital Heart Disease in the Adult

“…Therefore, when no other source of thromboembolism can be detected, a PFO may be suspected. 31 A number of other clinical syndromes are being studied for their apparent relationship to PFO, including migraine headache, 32,33 hypoxemia, 34 and decompression illness in divers and in people who work at altitude, 35 as well as high-altitude pulmonary edema. 36 The mechanism of the migraine relationship to PFO remains entirely unknown.…”