Late Results After Percutaneous Closure of Patent Foramen Ovale for Secondary Prevention of Paradoxical Embolism Using the Amplatzer PFO Occluder Without Intraprocedural Echocardiography

Abstract

The Amplatzer PFO Occluder affords excellent safety and long-term clinical efficacy of percutaneous PFO closure without intraprocedural echocardiography.

Long-term follow-up after closure of patent foramen ovale

“…Complete PFO closure is reported in 51-100% of patients [23], depending on device type and methodology used (transcranial Doppler, transoesophageal or transthoracic echocardiography), and the yearly recurrence rates of ischaemic strokes and transient ischaemic attacks (TIAs) vary between 0-5% [7].…”

“…Anatomical and physiological differences between PFOs and atrial septal defects led to the development of devices specifically designed for percutaneous PFO closure. Current devices for percutaneous PFO closure, such as the Amplatzer PFO Occluder, achieve complete PFO occlusion in >90% of cases with complication rates <1% and yearly recurrence rates <1% [23]. This improvement in device performance is likely to positively impact clinical outcome.…”

“…As reported in previous publications by our group, we performed systematic coronary angiography in patients undergoing percutaneous PFO closure aged CARDIOVASCULAR MEDICINE -KARDIOVASKULÄRE MEDIZIN -MÉDECINE CARDIOVASCULAIRE 2016;19(1): [19][20][21][22][23][24] >50 in males and >60 in females. In this study, a rather high proportion of the examined patients (29%) presented with unsuspected coronary artery disease, justifying incidental coronary angiography in selected patients.…”

Critique of Closure or Medical Therapy for Cryptogenic Stroke With Patent Foramen Ovale

“…This benchmark of effective closure was met in only 86%, a rate of closure that is less than what has been reported with contemporary devices such as the Amplatzer PFO occluder. 8 It should be noted that according to the CLOSURE I protocol, a shunt of grade 1 could be part of a successful procedural outcome and also was an inclusion criterion sufficient to be enrolled into the study. According to Furlan et al, 2 of the 909 subjects in the study, 428 (47%) had a "trace" shunt of 1 to 10 bubbles at baseline.…”

Optimal imaging for planning and guiding interventions in structural heart disease: a multi-modality imaging approach

“…37 Ongoing randomized, controlled trials will provide the best evidence on the safety and efficacy of transcatheter patent foramen ovale closure relative to antithrombotic therapy. 37 Although highly experienced centres have demonstrated successful transcatheter closure of patent foramen ovale with only fluoroscopic guidance, 41 the combination of fluoroscopy and echocardiography (transoesophageal or intracardiac) may constitute the best approach to achieve the highest success rate while minimizing the complications rate. 42 The interventional procedure is similar to the ASD closure procedure.…”