Transcatheter Amplatzer Device Closure of Atrial Septal Defect and Patent Foramen Ovale in Patients with Presumed Paradoxical Embolism

Anant Khositseth, Allison K. Cabalka, John P. Sweeney, F. David Fortuin, Guy S. Reeder, Heidi M. Connolly, Donald J. Hagler

Research output: Contribution to journalArticle

80 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)35-41
Number of pages7
JournalMayo Clinic proceedings
Volume79
Issue number1
DOIs
StatePublished - Jan 2004

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'Transcatheter Amplatzer Device Closure of Atrial Septal Defect and Patent Foramen Ovale in Patients with Presumed Paradoxical Embolism'. Together they form a unique fingerprint.

  • Cite this

    Khositseth, A., Cabalka, A. K., Sweeney, J. P., Fortuin, F. D., Reeder, G. S., Connolly, H. M., & Hagler, D. J. (2004). Transcatheter Amplatzer Device Closure of Atrial Septal Defect and Patent Foramen Ovale in Patients with Presumed Paradoxical Embolism. Mayo Clinic proceedings, 79(1), 35-41. https://doi.org/10.4065/79.1.35