Ten years of experience with closure of persistent foramen ovale: Patient characteristics and outcomes

Lehmann, Ralf; Fichtlscherer, Stephan; Baldauf, H; Schächinger, Volker; Auch-Schwelck, Wolfgang; Zeiher, Andreas M.; Teupe, Claudius

doi:10.1016/j.jjcc.2013.11.020

Cited by 12 publications

(4 citation statements)

References 10 publications

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“…It must be emphasized that closure of PFO is not risk-free [33], because surgical procedures to manage complications of transcatheter interventions may be needed in up to 8% of cases [34]. Although serious complications such as thrombus formation on the implant device, thromboembolism related to the implant device, cardiac perforation, infective endocarditis, and cardiac arrhythmias have been reported [33], the recent ''all-comers'' population in a study by Lehmann et al [35] documented the longterm safety of percutaneous PFO closure (cardiovascular event rate, 0.26 per 100 patient years). Sathasivam et al [33] concluded in their recent review that currently PFO closure cannot be recommended as a routine treatment for migraine for 3 main reasons: (1) the pathophysiological relevance of this procedure in migraine treatment is debatable; (2) the efficacy of this procedure in migraine treatment is inconclusively proven; and (3) the complications of this procedure may be serious and significant in comparison to the non-life threatening nature of migraine.…”

Section: Discussionmentioning

confidence: 99%

A meta-analysis of case-control studies of the association of migraine and patent foramen ovale

Takagi

Umemoto

2016

Journal of Cardiology

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Section: Discussionmentioning

confidence: 99%

A meta-analysis of case-control studies of the association of migraine and patent foramen ovale

Takagi

Umemoto

2016

Journal of Cardiology

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“…ASD je však najčastejšou vrodenou vývojovou chybou srdca diagnostikovanou v dospelosti s podielom viac ako 25 %. 1,2 Ak priemer defektu nepresahuje 5 mm a súčasne nie sú žiadne známky pravostranného objemového kardiálneho preťaženia, nie je terapia indikovaná. 3 Terapia ASD je indikovaná pri dokumentovanej náhlej cievnej mozgovej príhode alebo iných komplikáciách a/alebo ak priemer defektu je viac ako 5 mm a/alebo ak pomer pulmonálno-systémového tlaku (Qp : Qs) je minimálne 1,5 : 1.…”

Section: úVodunclassified

(Surgical remove of a dislocated Amplatzer septal occluder in the right pulmonary artery)

Toporcer¹,

Ledecký²,

Juhás³

et al. 2019

Cor Vasa

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Defekt predsieňového septa predstavuje 5,9 % všetkých vrodených vývojových chýb srdca. Perkutánna implantácia okluzora je často používanou stratégiou liečby tejto malformácie. Šesťdesiatpäť ročná žena bola prijatá za účelom perkutánneho uzáveru defektu predsieňového septa. Počas zákroku došlo k dislokácii Amplatzerovho okluzora do pravej pľúcnej tepny. Vykonaný bol kardiochirurgický zákrok s explantáciou dislokovaného okluzora, uzáverom defektu a vytvorením aortokoronárneho bypassu s dobrým výsledkom. Dislokácia okluzora počas uzáveru defektu predsieňového septa je vzácna, ale život ohrozujúca komplikácia. Najčastejšie vyžaduje kardiochirurgickú intervenciu s explantáciou dislokovaného zariadenia a chirurgickým uzáverom defektu. Perkutánny uzáver defektu predsieňového septa je moderný a efektívny prístup liečby. Vzhľadom na možné riziká procedúry, možnosť okamžitej kardiochirurgickej intervencie pri vzniku komplikácií zvyšuje bezpečnosť tohto postupu.

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“…The same analysis also examined 52 single-arm studies and, when combined with the comparative studies, found an incidence rate of 0.36 events (95 % CI, 0.24-0.56) per 100 person-years in the closure group versus 2.53 events (95 % CI, 1.91-3.35) per 100 person-years with medical therapy [19]. Lehmann et al reported on ten years of experience, describing 146 consecutive closures at a single center, with a mean follow-up of 7.8±3.1 years, during which 97.9 % of patients experienced no events [35].…”

Section: Evidence For Percutaneous Device Closurementioning

confidence: 99%

Role of Occlusive Devices to Prevent Thromboembolism Among Persons With a Patent Foramen Ovale and Prior Stroke

Roth

Alli

2015

Curr Treat Options Neurol

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Patent foramen ovale (PFO) has been linked to stroke, presumably through the mechanism of paradoxical embolism; however, data is confusing regarding the causal relationship between PFO and embolic stroke. What has come to light in the past decade of research is that PFO closure with devices that achieve a high rate of closure may reduce the risk of recurrent stroke compared with medical therapy, but this benefit has not been shown in the general population with a PFO and cryptogenic stroke. The important question now is which patient will benefit from PFO closure for stroke risk reduction. A validated risk prediction tool is needed to help physicians determine those patients who will derive benefit from closure of PFO to prevent recurrent stroke. It is clear that even in studies with a small number of individuals and a very small number of events, there is some benefit to closure. Furthermore, improvements in closure devices and techniques have made percutaneous device closure both safe and efficacious. As such, it is not necessary to wait for a patient to have two strokes prior to serious consideration of PFO closure. We would advocate that the decision to close a PFO in the setting of a cryptogenic stroke be made at an individual level, on a case-by-case basis. Patients with high-risk features may be more likely to benefit, though who exactly comprises this population is still being elucidated. The most difficult aspect of managing this disease is the substantial number of individuals with incidental PFOs, as well as the prevalence of stroke due to other etiologies. When treating this disease, the physician must be able to weigh the likelihood of benefit versus the risk of the procedure, as well as patient preference.

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Ten years of experience with closure of persistent foramen ovale: Patient characteristics and outcomes

Abstract: This "all-comers" population documents the safety of percutaneous PFO closure. The cardiovascular event rate is slightly lower (0.26 per 100 patient years) compared to the recently published randomized trials and maintained persistently low rate for more than 8 years.

Cited by 12 publications

References 10 publications

A meta-analysis of case-control studies of the association of migraine and patent foramen ovale

A meta-analysis of case-control studies of the association of migraine and patent foramen ovale

(Surgical remove of a dislocated Amplatzer septal occluder in the right pulmonary artery)

Role of Occlusive Devices to Prevent Thromboembolism Among Persons With a Patent Foramen Ovale and Prior Stroke

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