The incidence of thrombus formation on closure devices is low. The thrombus usually resolves under anticoagulation therapy.

Transcatheter treatment of ASA + PFO is safe and effective in patients with paradoxical embolism. The procedure effectively abolishes right-to-left shunt and decreases atrial septal mobility. Long-term prevention of recurrent events appears favorable when compared to patients with PFO alone.

Closing the LAA using the PLAATO system is feasible and can be performed at acceptable risk. It may become an alternative in patients with AF and a contraindication for lifelong anticoagulation treatment.

From December 1998 to August 2001, transcatheter closure of patent foramen ovale (PFO) with an Amplatzer PFO occluder has been successfully performed in our center in 102 patients without severe complications. We are reporting the first known case of cardiac perforation by an Amplatzer PFO occluder.

Patients with atrial fibrillation (AF) are at high risk of stroke. More than 15% of all strokes are due to atrial fibrillation. So far anticoagulation is the treatment of choice with a risk reduction of almost 70%. On the other hand, anticoagulation has many side effects such as intracranial or gastrointestinal hemorrhage. Closing the left atrial appendage (LAA) might be an alternative in patients who cannot take anticoagulation treatment due to contraindications or conditions in which the hazard of hemorrhage is greater than the potential clinical benefit. The PLAATO system (Percutaneous Left Atrial Appendage Transcatheter Occlusion) is a new device to close the LAA by the catheter technique. The device consists of a self-expandable nitinol cage that is covered with ePTFE. It is delivered via a specially designed 12F transseptal sheath. Small anchors along the struts prevent the occluder from embolizing. After device implantation patients are placed on aspirin only. The results of the dog model and the first clinical experiences in humans have been very promising.