Page 19 - Journal of Structural Heart Disease Volume 2, Issue 5

Original Research Article
220
Table 2: Univariate Analysis of Patient Characteristics and Echocardiographic Findings
25 mm Device
30 mm Device
35 mm Device
Variable
No. of patients
No. Male
Age
Height (cm)
Weight (kg)
BSA
Tunnel Length (mm) Percent with:
ASA
Long Tunnel Thickened Septum
18
7 (39%) 57 (12.5) 170 (12) 89.7 (31) 2.0 (0.3) 8.7 (3.2)
3 (17%) 4 (31%) 7 (39%)
16
5 (31%) 55 (16.2) 166 (9) 83.7 (19) 1.9 (0.2) 14.2 (6.5)
9 (56%) 6 (86%) 5 (31%)
2
1 (50%) 61.5 (4.9) 176 (16) 76 (8) 1.95 (0.2) 22
1 (50%) 1 (100%) 1 (50%)
p = 0.87 p = 0.82 p = 0.43 p = 0.68 p = 0.75 p = 0.007
p = 0.027 p = 0.038 p = 0.871
BSA = Body Surface Area. ASA = Atrial Septal Aneurysm, de ned as atrial septal excursion of >15 mm. Long Tunnel = PFO Tunnel Length on TEE or ICE >10 mm in length.
( ) denote stand deviation, unless otherwise noted.
Table 3:
A B C D E F G
List of hypothesized sizing scores tested
Score
Variables Included in Score
p = 0.26 p = 0.08 p = 0.41 p = 0.29 p = 0.21 p = 0.03 p = 0.007
1 point each for male sex and presence of ASA
1 point each for male sex, presence of ASA, and thickened septum
1 point each for male sex, tall height, and presence of ASA
1 point each for presence of ASA and thickened septum
1 point each for thickened septum, tall height, and presence of ASA
1 point each for male sex, presence of ASA, thickened septum, and long tunnel 1 point each for male sex, presence of ASA, and long tunnel
ASA = Atrial Septal Aneurysm, de ned as atrial septal excursion of >15 mm. Long Tunnel = PFO Tunnel Length on TEE or ICE >10 mm in length.
P values listed are results of Fisher’s Exact Test using STATA.
At this time there is no consensus regarding the se- lection of device size for PFO closure. A method utiliz- ing a sizing balloon to estimate appropriate device size has been described previously [15]. However, the use of sizing balloons carries some risk and may not provide meaningful information due to the relative compliance of the tissues of the intra-atrial septum [16]. A sizing balloon sitting across a slit-like or oval- shaped PFO may not adequately measure defect
length; therefore, operators typically select the size of closure device based on personal experience. This practice was re ected in the clinical trials assessing percutaneous PFO closure. In the RESPECT trial, the choice of device size was made at the discretion of the operator with the guidance of the Amplatzer PFO Oc- cluder instructions for use [22]. This device has a larger right atrial (RA) disc than left atrial (LA) disc with a cen- tral pin. Speci cally, the instructions suggest measur-
Journal of Structural Heart Disease, October 2016
Volume 2, Issue 5:217-223