TY - JOUR
T1 - Transcatheter Amplatzer Device Closure of Atrial Septal Defect and Patent Foramen Ovale in Patients with Presumed Paradoxical Embolism
AU - Khositseth, Anant
AU - Cabalka, Allison K.
AU - Sweeney, John P.
AU - Fortuin, F. David
AU - Reeder, Guy S.
AU - Connolly, Heidi M.
AU - Hagler, Donald J.
PY - 2004/1
Y1 - 2004/1
N2 - Objective: To review our experience with, and profile the safety and efficacy of, the Amplatzer PFO (patent foramen ovale) occluder (APO) and Amplatzer septal occluder (ASO) used to close PFO and/or atrial septal defect (ASD) in patients with paradoxical embolism (PE). Patients and Methods: Between April 1998 and November 2002, 103 patients at the Mayo Clinic in Rochester, Minn, and Scottsdale, Ariz, mean age 52.4 years, with presumed PE (transient ischemic attack [n=22], stroke [n=77], or peripheral emboli [n=4]) underwent transcatheter device closure of PFO (n=81), ASD (n=12), and ASD/PFO (n=10) with 106 devices (APO [n=22] or ASO [n=84]). Results: All devices deployed successfully, and no patients died. Procedural complications included atrial fibrillation (n=2), vessel injury (n=3), profound sinus node dysfunction (n=1), and device embolization with successful retrieval (n=1). At 3 months, 7 of 95 monitored patients had trivial residual shunt; at 12 months, 2 of 28 monitored patients had trivial residual shunt. Three patients had recurrent events-2 transient ischemic attacks and 1 retinal artery occlusion-at a mean ± SD follow-up of 8.3±8.1 months (range, 1-34 months). None of these 3 patients had residual shunt or evidence of intracardiac thrombus. The average annual recurrence of all events was 3.6% at 23 months. The overall mean ± SD freedom from recurrence of all events was 98.9%±1.2% and 83.8%±10.2% at 12 and 29 months of follow-up, respectively. Conclusions: Transcatheter device closure of PFO and/or ASD with use of APO/ASO in patients with presumed PE is effective and safe. Recurrent events may occur in the absence of a residual shunt.
AB - Objective: To review our experience with, and profile the safety and efficacy of, the Amplatzer PFO (patent foramen ovale) occluder (APO) and Amplatzer septal occluder (ASO) used to close PFO and/or atrial septal defect (ASD) in patients with paradoxical embolism (PE). Patients and Methods: Between April 1998 and November 2002, 103 patients at the Mayo Clinic in Rochester, Minn, and Scottsdale, Ariz, mean age 52.4 years, with presumed PE (transient ischemic attack [n=22], stroke [n=77], or peripheral emboli [n=4]) underwent transcatheter device closure of PFO (n=81), ASD (n=12), and ASD/PFO (n=10) with 106 devices (APO [n=22] or ASO [n=84]). Results: All devices deployed successfully, and no patients died. Procedural complications included atrial fibrillation (n=2), vessel injury (n=3), profound sinus node dysfunction (n=1), and device embolization with successful retrieval (n=1). At 3 months, 7 of 95 monitored patients had trivial residual shunt; at 12 months, 2 of 28 monitored patients had trivial residual shunt. Three patients had recurrent events-2 transient ischemic attacks and 1 retinal artery occlusion-at a mean ± SD follow-up of 8.3±8.1 months (range, 1-34 months). None of these 3 patients had residual shunt or evidence of intracardiac thrombus. The average annual recurrence of all events was 3.6% at 23 months. The overall mean ± SD freedom from recurrence of all events was 98.9%±1.2% and 83.8%±10.2% at 12 and 29 months of follow-up, respectively. Conclusions: Transcatheter device closure of PFO and/or ASD with use of APO/ASO in patients with presumed PE is effective and safe. Recurrent events may occur in the absence of a residual shunt.
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U2 - 10.4065/79.1.35
DO - 10.4065/79.1.35
M3 - Article
C2 - 14708946
AN - SCOPUS:0346362406
SN - 0025-6196
VL - 79
SP - 35
EP - 41
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 1
ER -