Early Experience with a Simplified Technique for Transcatheter Closure of the Patent Foramen Ovale

Shelby Kutty, David G. Nykanen, Evan M. Zahn

Research output: Contribution to journalArticle

Abstract

Background: Although generally safe, transcatheter patent foramen ovale (PFO) closure typically involves catheter exchanges and manipulations within the left atrium (LA) that may result in complications. We describe the development of a simplified technique for PFO closure, further to modification of our earlier approaches. Methods: Early in our experience, LA angiography and/or balloon sizing of the PFO was routine prior to device closure. Subsequently, the simplified technique described herein became our standard approach. We reviewed immediate and medium term results in 27 consecutive patients who underwent closure in a 24-month time frame. Results: All procedures used general anaesthesia, TEE guidance and CardioSEAL septal occluder. Device delivery was successful in all patients. The median fluoroscopy time was significantly shorter with the simplified technique (median difference 6.7. min, p< 0.05) with a 98.3% median confidence interval (4.5, 19.9. min). There were four complications, all occurring in the early group of patients. There have been no recurrent neurological events or device related adverse events on medium term follow-up. Conclusions: Successful transcatheter PFO closure is feasible without LA angiography or catheter-based balloon sizing, utilising echocardiographic guidance for device selection and placement. Simplification of PFO closure technique could potentially decrease complications and shorten fluoroscopy times.

Original languageEnglish (US)
Pages (from-to)384-387
Number of pages4
JournalHeart Lung and Circulation
Volume18
Issue number6
DOIs
StatePublished - Dec 1 2009
Externally publishedYes

Keywords

  • Adult congenital heart disease
  • Interventional catheterisation
  • Paediatric cardiology
  • Patent foramen ovale

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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