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Approaches to correct device malposition in percutaneous PFO closure: anatomical and technical implications
Andreas Muench1, Fernando Boccalandro, Keith Ellis
1Division of Cardiology, University of Texas, Houston Medical School, Houston, TX 77030, USA.
Summary
Transcatheter patent foramen ovale closure can fail initially. However, residual defects are often successfully closed, with persistent shunts corrected later, highlighting the importance of intracardiac ultrasound.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Patent foramen ovale (PFO) closure is a common transcatheter procedure.
- Initial procedural failure can occur, necessitating further intervention.
- Understanding reasons for failure is crucial for improving outcomes.
Observation:
- Three patients experienced initial failure of transcatheter PFO closure.
- Two patients had residual defects closed successfully during the index procedure.
- One patient presented with a persistent shunt requiring a subsequent intervention.
Findings:
- Initial transcatheter PFO closure failure is manageable.
- Residual defects can often be addressed in the same session.
- Persistent shunts may require delayed closure, emphasizing careful follow-up.
- Intracardiac ultrasound plays a vital role in assessment and guidance.
Implications:
- This case series highlights the potential for successful management of initial PFO closure failures.
- Anatomical and technical factors influence procedural success.
- The utility of intracardiac ultrasound in optimizing PFO closure outcomes is underscored.
- Further research into strategies for minimizing PFO closure failure is warranted.