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Outcomes of Patent Foramen Ovale Transcatheter Closure: Should a Short Aortic Rim Preclude Closure?
Ada C Stefanescu Schmidt1,2, Lusine Abrahamyan3,4,5, Annamalar Muthuppalaniappan1,6
1Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada.
JACC. Advances
|June 28, 2024
Summary
Device closure for patent foramen ovale (PFO) is safe in patients with a short aortic rim. The Amplatzer PFO device showed no erosion or embolization in a large cohort with long-term follow-up.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Device erosion risk with atrial septal occluders is higher in patients with a short aortic rim.
- Concerns exist for patent foramen ovale (PFO) closure devices, though erosion is rare.
- Fear of erosion may lead to underuse of PFO closure in certain patient groups.
Purpose of the Study:
- To assess outcomes of PFO closure using the Amplatzer PFO device.
- To specifically evaluate safety in patients with a short aortic rim (<9 mm).
Main Methods:
- Retrospective analysis of PFO closure cases between 2006-2017.
- Remasurement of preprocedural transesophageal echocardiographic parameters, including aortic rim.
- Long-term outcome data obtained via provincial administrative databases.
Main Results:
- 324 patients underwent PFO closure with the Amplatzer PFO device.
- 61% of patients had a short aortic rim (<9 mm).
- Over a median 7-year follow-up, no device erosion or embolization requiring surgery occurred.
Conclusions:
- Amplatzer PFO device implantation is safe in patients with a short aortic rim.
- Long-term follow-up in a large cohort supports the safety of PFO closure.
- The study provides evidence against excessive caution regarding device erosion in PFO closure.
