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Wallenborn, Julia; Bertog, Stefan C.; Franke, Jennifer; Steinberg, Daniel H.; Majunke, Nicolas; Wilson, Neil; Wunderlich, Nina; Sievert, Horst

Recurrent events after percutaneous closure of patent foramen ovale

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  • Medientyp: E-Artikel
  • Titel: Recurrent events after percutaneous closure of patent foramen ovale
  • Beteiligte: Wallenborn, Julia; Bertog, Stefan C.; Franke, Jennifer; Steinberg, Daniel H.; Majunke, Nicolas; Wilson, Neil; Wunderlich, Nina; Sievert, Horst
  • Erschienen: Wiley, 2013
  • Erschienen in: Catheterization and Cardiovascular Interventions
  • Sprache: Englisch
  • DOI: 10.1002/ccd.24511
  • ISSN: 1522-1946; 1522-726X
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec><jats:title>Objectives</jats:title><jats:p>To determine the incidence of symptomatic recurrent embolic events after patent foramen ovale (PFO) closure and potential causes for these events.</jats:p></jats:sec><jats:sec><jats:title>Background</jats:title><jats:p>It is well‐known that cerebral or other embolic events may occur after PFO closure.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This is a retrospective analysis of consecutive patients who underwent PFO closure for secondary prevention of embolic events at a single institution.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>1,930 patients (mean age of 50 ± 13.3 years) underwent transcatheter PFO closure. Complete closure occurred in 92%. The annual recurrence rate of embolic events before PFO closure was 22.4% (785 events in 3,497 patient‐years). During follow‐up (mean 39 months), 63 recurrent events were documented: 25 strokes, 36 transient ischemic attacks (TIAs), and 2 peripheral embolic events. The overall annual recurrence rate after the procedure was 1% per year (63 events in 6,211 patient‐years). The majority of events occurred in patients without residual shunts (54/63). There was no significant association between the presence of a residual shunt and recurrent events [hazard ratio (HR) 1.7; 95% confidence interval (CI) 0.8–3.6, <jats:italic>P</jats:italic> = 0.16]. The most common cause for recurrent events was atherosclerosis. Nine out of 63 events were considered likely or possible paradoxical embolism due to residual shunt [stroke (2), TIA (5), and peripheral embolism (2)]. After PFO closure, the annual rate of events potentially related to paradoxical embolism was 0.14% (9 events in 6,211 patient‐years).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The incidence of symptomatic embolic events after PFO closure is low. Most recurrent events are related to coexistent conditions associated with thromboembolic risk rather than residual shunts. © 2012 Wiley Periodicals, Inc.</jats:p></jats:sec>