Related Experiment Video
Updated: Jul 10, 2026
Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
Published on: December 23, 2022
Percutaneous Suture Closure of Patent Foramen Ovale With Right Atrial Septal Pouch
Francesco Maria Animati1, Gregory Angelo Sgueglia2, Antonella De Santis2
1Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy.
Background:
Right atrial septal pouch is an uncommon septal variant that may predispose to thrombosis. When associated with patent foramen ovale (PFO), it may provide a substrate for paradoxical embolism.
Fih/Early Reports Summary:
A 52-year-old woman with recurrent cryptogenic transient ischemic attacks underwent transesophageal echocardiography showing PFO, a small cribriform secundum defect, and right atrial septal pouch with right-to-left shunt. She underwent fluoroscopy and echocardiography-guided percutaneous direct suture closure. Postprocedural imaging confirmed complete shunt abolition and pouch inversion/collapse, without complications. At 30 days, she remained asymptomatic, with no residual shunt or thrombus.
Discussion:
This case supports the feasibility of suture-mediated PFO closure in complex septal anatomy requiring both shunt closure and pouch exclusion.
Novelty:
This is, to our knowledge, the first reported direct suture closure of PFO associated with right atrial septal pouch.
Take-Home Message:
Direct suture closure may offer a device-free alternative in selected PFO patients with complex anatomy.
