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The “pull–push” technique to deal with a redundant eustachian valve interfering with placement of a PFO occluder
Author(s) -
Butera Gianfranco,
Montinaro Antonio,
Carminati Mario
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.20903
Subject(s) - medicine , patent foramen ovale , interatrial septum , foramen ovale (heart) , catheter , sinus venosus , cardiology , surgery , atrial fibrillation , left atrium , percutaneous
Objectives : To evaluate the role of a new technique to deal with a redundant Eustachian valve (EV) interfering with placement of a patent foramen ovale (PFO) occluder. Background : The EV is a remnant of the embryonic valve of the sinus venosus. In rare occasions, it is large and redundant and it may interfere with catheters and devices used in cardiac catheterization. Methods : We have developed a new technique to control the EV in order to avoid interferences with the device for closure of atrial septal defects and PFO's. This technique is called “pull–push” technique and consists in pulling down on the inferior vena cava the redundant EV by using a 6 Fr pigtail catheter while a second operator pushes the right atrial disc out of the long sheath. Results : Here, we report on two patients with a patent foramen ovale, in whom the EV prevented the right atrial disc of an Amplatzer PFO occluder to be completely flat against the interatrial septum. Finally, we used this technique in one more patient to avoid any interference of a very redundant EV during placement of a Starflex device. Conclusions : 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 © 2006 Wiley‐Liss, Inc.