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Transcatheter closure of patent foramen ovale in older adults
Author(s) -
Kiblawi Fuad M.,
Sommer Robert J.,
Levchuck Sean G.
Publication year - 2006
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.20722
Subject(s) - medicine , patent foramen ovale , atrial fibrillation , stroke (engine) , headaches , sinus rhythm , surgery , cardiology , incidence (geometry) , pediatrics , migraine , mechanical engineering , physics , optics , engineering
Objectives: Comparing results of patent foramen ovale (PFO) closure in older and younger patient cohorts.Background: The literature pertaining to stroke and PFO has focused on patients <55 years of age.Methods: Between March 2000 and December 2003, 456 consecutive stroke/transient ischemic attack (TIA) patients (14.2–91.1 years, mean 51.4 ± 15.5) underwent successful closure of PFO with a CardioSEAL Septal Occluder by one operator at five hospitals. Of the 456 patients, 184 (40.4%) were >55years of age at the time of the procedure (mean 66.9 ± 8.3 years) and comprise the subject group (OLDER). The remaining 272 patients (mean 41.1 ± 7.7) comprise thecontrol group (YOUNGER). Data were collected prospectively in a registry type format.Results: Minor procedural complications were comparable: 7/184 (3.8%) OLDER vs. 12/272 (4.4%) YOUNGER ( P = NS). In the follow‐up period (1–45 months, mean = 17.8 ± 11.1), there was no significant difference in the rate of recurrent stroke/TIA, headaches, or late unrelated death. Forty OLDER patients and 47 YOUNGER developed new onset atrial arrhythmia ( P = NS). The incidence of new onset atrial fibrillation (AF), however, was significantly higher in OLDER (14/40 OLDER and only 2/47 YOUNGER, P < 0.025). All patients who were in normal sinus rhythm (NSR) before the procedure are in NSR at last follow‐up.Conclusions: Older patients should not be excluded from PFO closure. The procedure seems as safe and effective in preventing recurrent stroke in the older, as in the younger population. Older patients seem more prone to developing AF. © 2006 Wiley‐Liss, Inc.