Transthoracic Echocardiography Guidance during Percutaneous Closure of Patent Foramen Ovale

Abstract

Our study confirms the efficacy and safety of TTE guidance during percutaneous closure of PFO, which shortens the procedural time and obviates the need for general anesthesia or endotracheal intubation.

PFO closure with only fluoroscopic guidance: 7 years real‐world single centre experience

“…We think that reduction of fluoroscopy time is an important target especially in percutaneous PFO closure, which is usually performed in young patients. Nevertheless, in contrast with Oto et al , who reported a reduction in the fluoroscopy time through the years, we failed to show a reduction of fluoroscopy time and of total procedural time both for Echo‐G and Fluo‐G with acquisition of experience. Notably, even if Fluo‐G procedures theoretically need an adjunctive dose of contrast medium to perform the right atrium angiography, which is not performed in Echo‐G procedures, we do not report a difference in the quantity of contrast medium between the Echo‐G and Fluo‐G groups.…”

Guidelines for the Echocardiographic Assessment of Atrial Septal Defect and Patent Foramen Ovale: From the American Society of Echocardiography and Society for Cardiac Angiography and Interventions

“…It can also be used for patient selection and real-time transcatheter ASD or PFO closure procedural guidance in pediatric patients. 31,57,[62][63][64] TTE can be used for the initial evaluation of ASD and PFO in adults; however, TEE is required to further characterize the atrial septal abnormalities, because the TTE image quality will not always permit a comprehensive evaluation of the IAS. TEE is not invariably required for assessment of a PFO if transcatheter closure is not being considered.…”

Angiography vs transesophageal echocardiography‐guided patent foramen ovale closure: A propensity score matched analysis of a two‐center registry

“…The technical strategy for closure, however, remains an issue: Many studies have demonstrated that the fluoroscopic guidance is sufficient to drive the procedure, while others support the use of echocardiographic guidance . The latter is easily and safely performed by experienced operators and adds valuable information to the interventional cardiologist without significant adjunctive costs.…”

“…Many studies have demonstrated that the fluoroscopic guidance is sufficient to drive the procedure, 11,12 while others support the use of echocardiographic guidance. 13,22,23 The latter is easily and safely per- Some of the utilized devices are double-disk and self-centering.…”

“…9,10 The "gold-standard" procedural guidance technique, however, remains an issue. Some studies demonstrate that the angiographic guidance is sufficient to drive the procedure, 11,12 while others support the use of transesophageal echocardiography (TEE) guidance 13 as an additional tool to increase safety and efficacy. Intracardiac echocardiography allows a simplified procedure, even if more expensive and requiring a second vascular access.…”