Efficacy of percutaneous closure of patent foramen ovale: comparison among three commonly used occluders.

Autor:	Thaman R; Adult Congenital Heart Unit, Bristol Heart Institute, Bristol Royal Infirmary, Bristol, UK. rajesh.thaman@wales.nhs.uk, Faganello G, Gimeno JR, Szantho GV, Nelson M, Curtis S, Martin RP, Turner MS
Jazyk:	angličtina
Zdroj:	Heart (British Cardiac Society) [Heart] 2011 Mar; Vol. 97 (5), pp. 394-9.
DOI:	10.1136/hrt.2010.203950
Abstrakt:	Background: Percutaneous closure of patent foramen ovale (PFO) is standard treatment for patients with paradoxical embolism but studies examining the efficacy of the various occluders are lacking. Objective: To evaluate short- and medium-term closure rates of three common occluders. Methods: One hundred and sixty-six adults (47±12 (18-81 years)) were evaluated with transthoracic bubble echocardiography before and after PFO closure. Only patients with large PFOs were included (>30 bubbles in the left heart after Valsalva). Results: Three occluders were used: Amplatzer (AGA Medical Corporation) (n=80, 48%), Gore Helex (n=48, 29%) and Premere TM (St Jude Medical) (n=38, 23%). One (0.6%) neurological event occurred during follow-up. At 6 months significant residual shunting after Valsalva was highest in the group that received the Helex (58.3%), and lower for Premere (39.5%) and Amplatzer (32.5%). At final follow-up residual shunting remained higher in patients with the Helex (33.3%) than in Premere (18.5%) and Amplatzer (11%). Amplatzer had a significantly lower residual shunt rate than Helex (p<0.05 at 6 months and final follow-up). The Premere had an intermediate residual shunt rate. Septal aneurysm also predicted residual shunting (RR=24.7, 95% CI: 8.2 to 74.4, p<0.0001). Conclusions: Percutaneous PFO closure is an efficacious progressive treatment but closure rates also depend on the presence of aneurysm and differ between occluders.
Databáze:	MEDLINE
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