SCAI Guidelines for the Management of Patent Foramen Ovale

Kavinsky, Clifford J.; Goldsweig, Andrew M.; Amin, Zahid; Boudoulas, Konstantinos Dean; Carroll, John D.; Coylewright, Megan; Elmariah, Sammy; MacDonald, Lee A.; Shah, Atman P.; Spies, Christian; Tobis, Jonathan M.; Messé, Steven R.; Senerth, Emily; Falck‐Ytter, Yngve; Babatunde, Ifeoluwa

doi:10.1016/j.jscai.2022.100039

Cited by 70 publications

(77 citation statements)

References 61 publications

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“…Valsalva maneuvers, which are routine during bubble study investigations, can increase right-sided pressures, which may increase embolic events (42, 43). Intravenous filters (44, 45) and possible PFO closures (46) may be warranted for some patients with cryptogenic strokes.…”

Section: Discussionmentioning

confidence: 99%

Acute Respiratory Distress Syndrome and Shunt Detection With Bubble Studies: A Systematic Review and Meta-Analysis

Odenbach

Dhanoa

Sebastianski

et al. 2022

Critical Care Explorations

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Acute respiratory distress syndrome (ARDS) is a life-threatening respiratory injury with multiple physiological sequelae. Shunting of deoxygenated blood through intra-and extrapulmonary shunts may complicate ARDS management. Therefore, we conducted a systematic review to determine the prevalence of sonographically detected shunts, and their association with oxygenation and mortality in patients with ARDS.DATA SOURCES: Medical literature analysis and retrieval system online, Excerpta Medica dataBASE, Cochrane Library, and database of abstracts of reviews of effects databases on March 26, 2021. STUDY SELECTION:Articles relating to respiratory failure and sonographic shunt detection.DATA EXTRACTION: Articles were independently screened and extracted in duplicate. Data pertaining to study demographics and shunt detection were compiled for mortality and oxygenation outcomes. Risk of bias was appraised using the Joanna-Briggs Institute and the Newcastle-Ottawa Scale tools with evidence rating certainty using Grading of Recommendations Assessment, Development and Evaluation methodology.DATA SYNTHESIS: From 4,617 citations, 10 observational studies met eligibility criteria. Sonographic detection of right-to-left shunt was present in 21.8% of patients (range, 14.4-30.0%) among included studies using transthoracic, transesophageal, and transcranial bubble Doppler ultrasonographies. Shunt prevalence may be associated with increased mortality (risk ratio, 1.22; 95% CI, 1.01-1.49; p = 0.04, very low certainty evidence) with no difference in oxygenation as measured by Pao 2 :Fio 2 ratio (mean difference, -0.7; 95% CI, -18.6 to 17.2; p = 0.94, very low certainty).CONCLUSIONS: Intra-and extrapulmonary shunts are detected frequently in ARDS with ultrasound techniques. Shunts may increase mortality among patients with ARDS, but its association with oxygenation is uncertain.

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Section: Discussionmentioning

confidence: 99%

Acute Respiratory Distress Syndrome and Shunt Detection With Bubble Studies: A Systematic Review and Meta-Analysis

Odenbach

Dhanoa

Sebastianski

et al. 2022

Critical Care Explorations

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“…In this multi-center, observational registry, adult patients ≥18 years old, with a clinical indication for PFO closure according to the current guidelines, treated with the Cocoon PFO Occluder were consecutively included (4)(5)(6). All the patients treated with Cocoon PFO Occluder at the participating centers were sequentially included in the registry in a prospective way and data where then analyzed retrospectively.…”

Section: Patient Population and Study Designmentioning

confidence: 99%

“…The presence of patent foramen ovale (PFO) can be detected in about 25% of the adult population, with implication in the pathogenesis of different medical conditions as cryptogenic stroke, decompression illness, platypnea-orthodeoxia syndrome and, although still controversial, migraine with aura (1)(2)(3). When PFO closure is indicated, percutaneous closure is recommended as the method of choice (4)(5)(6). In this regards, multiple observational studies, meta-analyses and trials have shown a benefit of percutaneous PFO closure, demonstrating favorable long-term results in terms of efficacy in preventing recurrence of stroke, improvement in quality of life and cost-effectiveness of this procedure when compared to medical therapy, thus increasing the popularity of this procedure (7)(8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Patent foramen ovale occlusion with the Cocoon PFO Occluder. The PROS-IT collaborative project

Testa

Rubbio²,

Squillace³

et al. 2023

Front. Cardiovasc. Med.

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BackgroundThe Cocoon patent foramen ovale (PFO) Occluder is a new generation nitinol alloy double-disk device coated with nanoplatinum, likely useful in patients with nickel hypersensitivity. Early results and mid-term outcomes of this device in percutaneous PFO closure are missing.AimsTo assess the preliminary efficacy and safety profile of PFO closure with Cocoon device in an Italian multi-center registry.MethodsThis is a prospective registry of 189 consecutive adult patients treated with the Cocoon PFO Occluder at 15 Italian centers from May 2017 till May 2020. Patients were followed up for 2 years.ResultsClosure of the PFO with Cocoon Occluder was carried out successfully in all patients, with complete closure without residual shunt in 94.7% of the patients and minimal shunt in 5.3%. Except from a case of paroxysmal supraventricular tachycardia and a major vascular bleeding, no procedural and in-hospital device-related complications occurred. No patient developed cardiac erosions, allergic reactions to nickel, or any other major complications during the follow-up. During the follow-up period, 2 cases of new-onset atrial fibrillation occurred within thirty-day.ConclusionsPercutaneous closure of PFO with Cocoon Occluder provided satisfactory procedural and mid-term clinical follow-up results in a real-world registry.

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“…The Food and Drug Administration approved the use of percutaneous transcatheter closure (PTC) for PFO because closure can significantly decrease the rate of recurrent stroke. Furthermore, the Society for Cardiovascular Angiography and Interventions (SCAI) guidelines recommend PFO closure in patients with prior PFO-associated stroke[ 4 ]. PFO diagnosis involves transoesophageal echocardiography (TEE), transthoracic echocardiography (TTE), transcranial Doppler (TCD), and intracardiac echocardiography (ICE)[ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Novel way of patent foramen ovale detection and percutaneous closure by intracardiac echocardiography: A case report

Han¹,

Yang²,

Zhou³

2022

World J Clin Cases

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BACKGROUND Patent foramen ovale (PFO) is the most common congenital heart disease and is associated with several diseases, including stroke and migraine. PFO diagnosis involves transoesophageal echocardiography, transthoracic echocardiography, and transcranial Doppler. Recent studies have shown that intracardiac echocardiography (ICE) can be used to diagnose and guide percutaneous transcatheter closure. CASE SUMMARY A 70-year-old male presented with paroxysmal dizziness and limb weakness for the past 3 mo. Magnetic resonance imaging revealed a history of stroke, and a bubble test revealed the presence of PFO. The patient was then transferred to our hospital for PFO closure. Under ICE guidance, the separation of the septum primum and septum secundum was unclear; we then used a Swartz catheter to confirm PFO by applying physical pressure on the right part of the atrial septum without using any contrast. The ICE continuously and clearly guided the procedure. CONCLUSION ICE can guide PFO closure in patients with a history of stroke. When PFO is not evident under ICE, a Swartz catheter can be used.

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SCAI Guidelines for the Management of Patent Foramen Ovale

Cited by 70 publications

References 61 publications

Acute Respiratory Distress Syndrome and Shunt Detection With Bubble Studies: A Systematic Review and Meta-Analysis

Acute Respiratory Distress Syndrome and Shunt Detection With Bubble Studies: A Systematic Review and Meta-Analysis

Patent foramen ovale occlusion with the Cocoon PFO Occluder. The PROS-IT collaborative project

Novel way of patent foramen ovale detection and percutaneous closure by intracardiac echocardiography: A case report

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