Dejan Nachoski1, Joerg Schroeder2, Mohammad Almalla2, Ralf Kubini1, Vadim Tchaikovski1, Christoph Kosinski3, Michael Becker1, Ali Aljalloud1,4. 1. Rhein-Maas Hospital, Department of Cardiology, Nephrology and Internal Intensive Care, Würselen, Germany. 2. RWTH University Hospital Aachen, Department of Cardiology, Pulmonology and Internal Itensive Care, Aachen, Germany. 3. Rhein-Maas Hospital, Department of Neurology, Würselen, Germany. 4. RWTH University Hospital Aachen, Department of Cardiac Surgery, Aachen, Germany.
Abstract
BACKGROUND: Current guidelines recommend interventional closure of patent foramen ovale (PFO) in patients with cryptogenic ischemic stroke who are under 60 years of age. HYPOTHESIS: The hypothesis of this study was to compare follow-up results of PFO closure in patients over 60 years of age to those of patients under 60 years of age in order to determine whether the procedure is safe and effective for both age groups. METHODS: We included 293 patients who had a cryptogenic ischemic stroke and a PFO confirmed by transesophageal echocardiography (TEE) and who were scheduled for percutaneous closure of the PFO between 2014 and 2019. The device implantation was completed in all patients using an Amplatzer™, Occlutec™, or Cardia Ultrasept PFO occluder. RESULTS: Follow-up TEE examinations were performed at intervals of 1, 3, and 6 months after implantation. Patients were followed for a median of 3.6 ± 1.2 years. Recurrent ischemic stroke or transient ischemic attack, cardiac death, arrhythmias, and residual shunt were reported equally in both groups. CONCLUSIONS: Interventional closure of PFO can be as safe and effective in patients over 60 years of age as it is in patients under 60 years of age regardless of the device used. In this older patient group, rigorous discussion and a case-by-case decision-making process including cardiologists and neurologists is warranted to ensure optimal procedure selection.
BACKGROUND: Current guidelines recommend interventional closure of patent foramen ovale (PFO) in patients with cryptogenic ischemic stroke who are under 60 years of age. HYPOTHESIS: The hypothesis of this study was to compare follow-up results of PFO closure in patients over 60 years of age to those of patients under 60 years of age in order to determine whether the procedure is safe and effective for both age groups. METHODS: We included 293 patients who had a cryptogenic ischemic stroke and a PFO confirmed by transesophageal echocardiography (TEE) and who were scheduled for percutaneous closure of the PFO between 2014 and 2019. The device implantation was completed in all patients using an Amplatzer™, Occlutec™, or Cardia Ultrasept PFO occluder. RESULTS: Follow-up TEE examinations were performed at intervals of 1, 3, and 6 months after implantation. Patients were followed for a median of 3.6 ± 1.2 years. Recurrent ischemic stroke or transient ischemic attack, cardiac death, arrhythmias, and residual shunt were reported equally in both groups. CONCLUSIONS: Interventional closure of PFO can be as safe and effective in patients over 60 years of age as it is in patients under 60 years of age regardless of the device used. In this older patient group, rigorous discussion and a case-by-case decision-making process including cardiologists and neurologists is warranted to ensure optimal procedure selection.
Authors: David M Kent; Issa J Dahabreh; Robin Ruthazer; Anthony J Furlan; Mark Reisman; John D Carroll; Jeffrey L Saver; Richard W Smalling; Peter Jüni; Heinrich P Mattle; Bernhard Meier; David E Thaler Journal: J Am Coll Cardiol Date: 2016-03-01 Impact factor: 24.094
Authors: Irene Meissner; Bijoy K Khandheria; John A Heit; George W Petty; Sheldon G Sheps; Gary L Schwartz; Jack P Whisnant; David O Wiebers; Jody L Covalt; Tanya M Petterson; Teresa J H Christianson; Yoram Agmon Journal: J Am Coll Cardiol Date: 2005-12-06 Impact factor: 24.094
Authors: Lars Søndergaard; Scott E Kasner; John F Rhodes; Grethe Andersen; Helle K Iversen; Jens E Nielsen-Kudsk; Magnus Settergren; Christina Sjöstrand; Risto O Roine; David Hildick-Smith; J David Spence; Lars Thomassen Journal: N Engl J Med Date: 2017-09-14 Impact factor: 91.245
Authors: Linxin Li; Gabriel S Yiin; Olivia C Geraghty; Ursula G Schulz; Wilhelm Kuker; Ziyah Mehta; Peter M Rothwell Journal: Lancet Neurol Date: 2015-07-27 Impact factor: 59.935