The “pull–push” technique to deal with a redundant eustachian valve interfering with placement of a PFO occluder

Butera, Gianfranco; Montinaro, Antonio; Carminati, Mário

doi:10.1002/ccd.20903

Cited by 14 publications

(7 citation statements)

References 5 publications

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“…The classic tunnel-like anatomy of PFO may be more complex for the presence of several associated defects such as: large defects (greater than 4 mm), ASA, HEV and septal multiple cribrosity (SMC) [Meier, 2009;Roelandt and Budts, 2009;Butera et al 2006].…”

Section: Introductionmentioning

confidence: 99%

The new patent foramen ovale occluder FIGULLA in complex septal anatomy: a case series

Baglini¹,

Baldari²,

Amaducci³

et al. 2012

Therapeutic Advances in Cardiovascular Disease

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Background: The appropriate treatment strategy for secondary stroke prevention in patients with cryptogenic stroke and patent foramen ovale (PFO) remains challenging. The aim of this study was to describe a case series of patients with PFO and complex septal anatomy who underwent percutaneous correction using a FIGULLA (Occlutech®) septal occluder (FSO). Patients: Ten consecutive patients (6 females, 4 males, mean age 41.6 ± 16.0 years, range 17-52 years; Group 1) with cryptogenetic stroke and/or transient cerebral ischemia and complex septal anatomy, as defined by intraprocedural transesophageal echocardiogram (TEE) were compared with a group of 25 patients (10 females, 15 males, mean age 43.7 ± 12.3 years; Group 2) with usual tunnel-like PFO anatomy in whom PFO was closed by an Amplatzer septal occluder (ASO; AGA®). Results: No significant differences were noted between Group 1 and Group 2 for immediate success rate, residual intraprosthetic shunt at the end of the procedure, discharge, 1, 6 and 12 months follow up, number of attempts, procedure time, fluoroscopy time, or cardiac complication (atrial arrhythmias, device embolism). The only significant difference was shown for delivery sheath size (11 ± 2 versus 9 ± 1 F) and incidence of local hematoma (30% versus 12 %) between Group 1 and Group 2, without any clinical consequence (need of transfusion) or increase in length of stay. Conclusion: FSO shows high performance in patients with PFO and complex septal anatomy when compared with patients with PFO and uncomplicated atrial anatomy treated by ASO. Its favorable behavior is probably related to fabric features such as the total amount of metal and the presence of titanium.

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Section: Introductionmentioning

confidence: 99%

The new patent foramen ovale occluder FIGULLA in complex septal anatomy: a case series

Baglini¹,

Baldari²,

Amaducci³

et al. 2012

Therapeutic Advances in Cardiovascular Disease

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“…The device delivery cable may cause entrapment of the EV and inadvertent extraction of the EV (5). Furthermore, the prominent EV prevents apposition of the RA disc onto the septum and there may be residual atrial septal level shunt and predisposition to thrombus formation (6). There are reports of inadvertent surgical closure of a prominent Eustachian valve which was mistaken for an ASD where the patient presented with features of worsening cyanosis and IVC obstruction(7)(8).…”

Section: Discussionmentioning

confidence: 99%

Utility of Eustachian valve for facilitating ASD device closures in defects with borderline mitral rims

Kurup¹,

Gopalakrishnan²,

Sasikumar³

et al. 2021

Preprint

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A prominent Eustachian valve in the right atrium has been reported to pose significant challenges during device closure of atrial septal defects. We describe the procedural aspects of device closure in an ASD with deficient rims and a redundant Eustachian valve. The prominent Eustachian valve provided extra stability in the anteroinferior aspect during device deployment and hence proved to be helpful for the procedure. It is important to consider this aspect while planning device closure

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“…Difficulty in the advancement of the dual‐stage cannula into the IVC from the right atrium has been reported in patients with Giant EV 2 . It can even cause difficulties in device closure of a patent foramen ovale and in pacemaker lead insertion 3,4 . Sometimes, EV can be misinterpreted as inter‐atrial septum (IAS), leading to inadvertent surgical closure and percutaneous closure of EV to IAS 5 .…”

Section: Discussionmentioning

confidence: 99%

Giant Eustachian valve and Thebesian valve—A highly deceptive structures as atrial septal defect rims

Damodaran

Gourav

Negi

et al. 2020

J of Clinical Ultrasound

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The Eustachian valve (EV) of the inferior vena cava and the Thebesian valve (TV) of the coronary sinus are incompletely regressed structures of embryonic sinus venosus. In the majority of cases, the EV and TV disappear completely after birth or are represented only by a thin crescentic fold. On echocardiography, these vestiges may mimic abnormal structures. We report a case with giant EV and TV which were initially misinterpreted as rims of an atrial septal defect (ASD) leading to the false diagnosis of ostium secundum ASD.

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The “pull–push” technique to deal with a redundant eustachian valve interfering with placement of a PFO occluder

Abstract: In conclusion. the so called "pull-push" technique is an alternative and easy technique to control the EV in order to avoid interferences with the device for closure of atrial septal defects and PFO's

Cited by 14 publications

References 5 publications

The new patent foramen ovale occluder FIGULLA in complex septal anatomy: a case series

The new patent foramen ovale occluder FIGULLA in complex septal anatomy: a case series

Utility of Eustachian valve for facilitating ASD device closures in defects with borderline mitral rims

Giant Eustachian valve and Thebesian valve—A highly deceptive structures as atrial septal defect rims

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