BACKGROUND: Patent foramen ovale (PFO) has been linked to cryptogenic stroke, and closure has been reported to improve clinical outcomes. However, there are no clear guidelines to direct device sizing. This study sought to use patient characteristics and echocardiographic findings to create a prediction score for device sizing. METHODS: This was a retrospective review of patients undergoing percutaneous PFO closure at our institution between July 2010 and December 2014. Demographic and clinical characteristics were recorded, and all pre- and intraprocedural echocardiography results were evaluated. RESULTS: Thirty-six patients underwent percutaneous PFO closure during the study period. All procedures were performed using an Amplatzer Septal Occluder "Cribriform" (ASOC) device in one of three disc diameters: 25, 30, or 35 mm. Closure was indicated for cryptogenic stroke/transient ischemic attack in 75% of cases. Every case (100%) was successful with durable shunt correction at the 6-month follow-up without complications of erosion or device embolization. The presence of atrial septal aneurysm (ASA) (p = 0.027) and PFO tunnel length >10 mm (p = 0.038) were independently associated with increased device size. A scoring system of 1 point for male sex, 1 point for ASA, and 1 point for PFO tunnel >10 mm long was associated with the size of closure device implanted (p = 0.006). CONCLUSIONS: A simple scoring system may be used to select an optimally sized device for percutaneous PFO closure using the ASOC device.
BACKGROUND: Patent foramen ovale (PFO) has been linked to cryptogenic stroke, and closure has been reported to improve clinical outcomes. However, there are no clear guidelines to direct device sizing. This study sought to use patient characteristics and echocardiographic findings to create a prediction score for device sizing. METHODS: This was a retrospective review of patients undergoing percutaneous PFO closure at our institution between July 2010 and December 2014. Demographic and clinical characteristics were recorded, and all pre- and intraprocedural echocardiography results were evaluated. RESULTS: Thirty-six patients underwent percutaneous PFO closure during the study period. All procedures were performed using an Amplatzer Septal Occluder "Cribriform" (ASOC) device in one of three disc diameters: 25, 30, or 35 mm. Closure was indicated for cryptogenic stroke/transient ischemic attack in 75% of cases. Every case (100%) was successful with durable shunt correction at the 6-month follow-up without complications of erosion or device embolization. The presence of atrial septal aneurysm (ASA) (p = 0.027) and PFO tunnel length >10 mm (p = 0.038) were independently associated with increased device size. A scoring system of 1 point for male sex, 1 point for ASA, and 1 point for PFO tunnel >10 mm long was associated with the size of closure device implanted (p = 0.006). CONCLUSIONS: A simple scoring system may be used to select an optimally sized device for percutaneous PFO closure using the ASOC device.
Authors: Leo H Bonati; Arnheid Kessel-Schaefer; André Z Linka; Peter Buser; Stephan G Wetzel; Ernst-Wilhelm Radue; Philippe A Lyrer; Stefan T Engelter Journal: Stroke Date: 2006-06-29 Impact factor: 7.914
Authors: Anthony J Furlan; Mark Reisman; Joseph Massaro; Laura Mauri; Harold Adams; Gregory W Albers; Robert Felberg; Howard Herrmann; Saibal Kar; Michael Landzberg; Albert Raizner; Lawrence Wechsler Journal: N Engl J Med Date: 2012-03-15 Impact factor: 91.245
Authors: I Meissner; J P Whisnant; B K Khandheria; P C Spittell; W M O'Fallon; R D Pascoe; M Enriquez-Sarano; J B Seward; J L Covalt; J D Sicks; D O Wiebers Journal: Mayo Clin Proc Date: 1999-09 Impact factor: 7.616
Authors: Ignacio Inglessis; Sammy Elmariah; Pablo A Rengifo-Moreno; Ronan Margey; Caitlin O'Callaghan; Ignacio Cruz-Gonzalez; Suzanne Baron; Praveen Mehrotra; Timothy C Tan; Judy Hung; Zareh N Demirjian; Ferdinando S Buonanno; MingMing Ning; Scott B Silverman; Roberto J Cubeddu; Eugene Pomerantsev; Robert M Schainfeld; G William Dec; Igor F Palacios Journal: JACC Cardiovasc Interv Date: 2013-11 Impact factor: 11.195
Authors: Andreas Wahl; Tony Tai; Fabien Praz; Markus Schwerzmann; Christian Seiler; Krassen Nedeltchev; Stephan Windecker; Heinrich P Mattle; Bernhard Meier Journal: JACC Cardiovasc Interv Date: 2009-02 Impact factor: 11.195
Authors: John D Carroll; Jeffrey L Saver; David E Thaler; Richard W Smalling; Scott Berry; Lee A MacDonald; David S Marks; David L Tirschwell Journal: N Engl J Med Date: 2013-03-21 Impact factor: 91.245