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Recurrent events following patent foramen ovale closure in patients above 55 years of age with presumed paradoxical embolism
Author(s) -
Spies Christian,
Khandelwal Abha,
Timmemanns Ines,
Kavinsky Clifford J.,
Schräder Rainer,
Hijazi Ziyad M.
Publication year - 2008
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.21737
Subject(s) - medicine , patent foramen ovale , paradoxical embolism , incidence (geometry) , surgery , intracardiac injection , shunt (medical) , fluoroscopy , pediatrics , percutaneous , physics , optics
Abstract Objectives: The aim of this article is to summarize our experience of patent foramen ovale (PFO) closure in patients above the age of 55 years. Background: PFO is associated with cryptogenic thromboembolic events (TEs) in patients younger than 55 years. Little is known about the recurrence rate of TE in patients above the age of 55 years undergoing PFO closure for presumed paradoxical embolism. Methods: PFO closure was performed in 1,055 patients, 423 of whom were above 55 years of age. Implantation of the device was guided by fluoroscopy and transesophageal or intracardiac echocardiography. Results: A PFO occluding device was implanted successfully in all patients. Residual shunt was documented in 10% of patients above 55 years of age and in 8.4% of patients aged 55 years or younger ( P = 0.325). During a median follow‐up period of 18 months (range, 0–162 months) the annual incidence of recurrent TE in patients above 55 years was 1.8% while patients aged 55 or below had an annual incidence of recurrent TE of 1.3%. TE‐free survival was similar in patients above 55 years of age compared with those aged 55 years and below. Conclusions: PFO closure in older patients is as efficient and seems comparable to those under the age of 55. Although traditional cardiovascular risk factors may be more frequent in the older age group compared with those younger than 55 years, PFO closure should not be withheld as a possible therapeutic option in this age group. © 2008 Wiley‐Liss, Inc.