Transcatheter Closure of Patent Foramen Ovale in Patients with Platypnea-Orthodeoxia: Results of a Multicentric French Registry

Journal Article · Fri Apr 15 00:00:00 EDT 2005 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-004-0035-3· OSTI ID:21088142

Lambert, V ^[1]; Godart, F ^[2]; Legendre, A; Petit, J ^[1]; Bourlon, F ^[3]; Geeter, B de ^[4]; Petit, A ^[5]; Monrozier, B ^[6]; Rossignol, A M ^[7]; Jimenez, M ^[8]; Crochet, D ^[9]; Choussat, A ^[10]; Rey, C ^[2]; Losay, J ^[1]

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1. Centre chirurgical Marie Lannelongue (France)
2. Hopital de cardiologie, CHU Lille (France)
3. Centre cardiothoracique de Monaco (Monte Carlo) (Monaco)
4. Clinique Saint Odile (France)
5. CHU Dijon (France)
6. Hopital de cardiologie, CHU Lyon (France)
7. Hopital A. Michalon, CHU de Grenoble (France)
8. Hopital du Haut Leveque, CHU de Bordeaux (France)
9. CHU Nantes, Hopital G. et R. Laennec (France)
10. Deceased. Formerly Hopital cardiologique du Haut Leveque, CHU Bordeaux (France)

Background. Dyspnea and the decrease in arterial saturation in the upright position in elderly subjects is described as platypnea-orthodeoxia syndrome (POS). POS is secondary to the occurrence of an atrial right-to-left shunt through a patent foramen ovale (PFO). Methods. This French multicentric study reports on 78 patients (mean age 67 {+-} 11.3 years) with POS who had transcatheter closure of the PFO; frequently associated diseases were pneumonectomy (n = 36) and an ascending aortic aneurysm (n = 11). In all patients, the diagnosis was confirmed by transthoracic or/and transesophageal echocardiography. Five different closure devices were used: Amplatz (n = 45), Cardioseal (n = 13), Sideris (n = 11), Das Angel Wings (n = 8) and Starflex (n = 1). Closure was successful in 76 patients (97%). Results. Oxygen saturation increased immediately after occlusion from 84.6 {+-} 10.7% to 95.1 {+-} 6.4% (p < 0.001) and dyspnea improved from grade 2.7 {+-} 0.7 to grade 1 {+-} 1 (p < 0.001). A small residual shunt was immediately observed in 5 patients (3 with the Cardioseal device, 1 with the Sideris and 1 with the Amplatz) leading to the implantation of a second device in one case (Cardioseal). Two early deaths occurred unrelated to the procedure (one due to sepsis probably related to pneumonectomy, another due to respiratory insufficiency). Other complications were: a small shunt between the aorta and the left atrium, two atrial fibrillations and a left-sided thrombus which disappeared with anticoagulant therapy. At a mean follow-up of 15 {+-} 12 months, there were 7 late deaths related to the underlying disease. Conclusion. Percutaneous occlusion of the foramen ovale is safe and gives excellent results thanks to continuing improvement in available devices. This technique enables some patients in an unstable condition to avoid a surgical closure.

• OSTI ID: 21088142
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 2 Vol. 28; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
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DIAGNOSIS
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