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Implantation of a second closure device in patients with residual shunt after percutaneous closure of patent foramen ovale
Author(s) -
Schwerzmann Markus,
Windecker Stephan,
Wahl Andreas,
Nedeltchev Krassen,
Mattle Heinrich P.,
Seiler Christian,
Meier Bernhard
Publication year - 2004
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20221
Subject(s) - medicine , patent foramen ovale , percutaneous , shunt (medical) , surgery , fluoroscopy , paradoxical embolism , occlusion , closure (psychology) , cardiology , economics , market economy
Percutaneous closure of patent foramen ovale (PFO) in patients with presumed paradoxical embolism yields complete occlusion in > 90% of patients using contemporary closure devices. Patients with a residual shunt after percutaneous PFO closure have been found at increased risk for recurrent paradoxical events. Treatment options for such patients include medical treatment using antiplatelet drugs or oral anticoagulation, surgical device removal and patch closure, and percutaneous implantation of a second closure device. We report our experience with implantation of a second closure device in 10 patients with more than a minimal residual shunt ≤ 6 months after percutaneous PFO closure. Procedure and fluoroscopy times were similar for the initial and repeat intervention (32 vs. 30 min and 5 vs. 6 min, respectively; P = NS). There were no procedural complications during implantation of the second closure device. Follow‐up transesophageal echocardiography 6 months after the second percutaneous intervention revealed complete PFO closure in nine (90%) patients. Therefore, implantation of a second closure device in patients with persistence of more than a residual shunt after percutaneous PFO closure appears safe and effective. Catheter Cardiovasc Interv 2004;63:490–495. © 2004 Wiley‐Liss, Inc.