ABSTRACT
BACKGROUND:
A percutaneous
patent foramen ovale (PFO) closure
procedure includes transesophageal or intracardiac echocardiographic guidance at many centers. We investigated the feasibility and
complications of the PFO closure without
echocardiography.
METHODS AND
RESULTS:
A total of 420 consecutive
patients (185
women and 235
men, mean age 51 +/- 12 years) underwent percutaneous PFO closure without echocardiographic guidance using 7 different
devices. Of these, 106
patients (25%) had an associated atrial septal
aneurysm. The implantation was successful in 418
patients (99%). There were 12 procedural
complications (3%), including embolization of the
device or of parts of it with successful percutaneous removal in 5 cases,
pericardial tamponade requiring
pericardiocentesis in 1
patient,
air embolism with
transient symptoms in 3
patients, and vascular access problems in 3
patients. In none of the cases,
echocardiography had to be summoned during the case or its lack was associated with acute or subsequent problems. The
fluoroscopy time and
procedure time were 5.4 +/- 2.7 and 25 +/- 17 minutes, respectively. Transthoracic
contrast echocardiography, 24 hours after
device implantation, detected a residual shunt in 19% of the
patients.
CONCLUSIONS:
Percutaneous PFO closure with fluoroscopic guidance only is feasible and has low complication rates, especially with Amplatzer PFO Occluders. The added
time and
cost of
echocardiography during the
procedure is not warranted.
