Device closure of patent foramen ovale—Do similar devices achieve similar results?

Abstract

Patent foramen ovale (PFO) has been implicated in the pathogenesis of stroke and migraine. Although randomized trials have not, as of yet, reiterated the salutary effects on stroke and migraine seen in observational and case controlled studies, there doubtless exist a segment of the PFO population that benefit from percutaneous PFO closure.In this issue of CCI, Saguner et al., report an interesting study comparing the Figulla PFO occlusion device (FPO) with the Amplatzer PFO occluder (APFO) [1]. Employing a single-center, case control comparative design, the authors compared 20 patients receiving the FPO implanted for prevention of recurrent paradoxical embolism to 20 patients previously receiving an APFO, presumably for the same indication. Although specifically not stated, the comparison of the two devices was performed to assess acute and longer-term differences as relates to device performance and residual cardiac shunting following PFO closure. There were trends suggesting diminished procedural success and more periprocedural complications in the FPO group. The FPO patients demonstrated significantly more residual shunts with two patients undergoing additional device implantation with Amplatzer occluders.

The evolving role of echocardiography in the assessment of patent foramen ovale in patients with left‐side thromboembolism

“…A prominent Eustachian valve (more than 10 mm) and an ectatic aortic root represent further difficulties. Thus, despite few studies compared different types of PFO occluders, [54][55][56][57] echocardiography may help choosing the device type, sizing and technique for positioning.…”