Original Research Articles
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Journal of Structural Heart Disease, October 2016, Volume 2, Issue 5:217-223
DOI: 10.12945/j.jshd.2016.009.15
A Practical Scoring System to Select Optimally Sized Devices for Percutaneous Patent Foramen Ovale Closure
Joseph M. Venturini, MD*, Elizabeth M. Retzer, MD, J. Raider Estrada, MD, Anuj Mediratta, MD, Janet Friant, MSN, Sandeep Nathan, MD, Jonathan D. Paul, MD, John Blair, MD, Roberto M. Lang, MD, Atman P. Shah, MD
Section of Cardiology, Department of Medicine, University of Chicago, Chicago, Illinois, USA
Abstract
Background: Patent foramen ovale (PFO) has been linked to cryptogenic stroke, and closure has been reported to improve clinical outcomes. However, there are no clear guidelines to direct device sizing. This study sought to use patient characteristics and echocardiographic findings to create a prediction score for device sizing.
Methods: This was a retrospective review of patients undergoing percutaneous PFO closure at our institution between July 2010 and December 2014. Demographic and clinical characteristics were recorded, and all pre- and intraprocedural echocardiography results were evaluated.
Results: Thirty-six patients underwent percutaneous PFO closure during the study period. All procedures were performed using an Amplatzer Septal Occluder “Cribriform” (ASOC) device in one of three disc diameters: 25, 30, or 35 mm. Closure was indicated for cryptogenic stroke/transient ischemic attack in 75% of cases. Every case (100%) was successful with durable shunt correction at the 6-month follow-up without complications of erosion or device embolization. The presence of atrial septal aneurysm (ASA) (p = 0.027) and PFO tunnel length >10 mm (p = 0.038) were independently associated with increased device size. A scoring system of 1 point for male sex, 1 point for ASA, and 1 point for PFO tunnel >10 mm long was associated with the size of closure device implanted (p = 0.006).
Conclusions: A simple scoring system may be used to select an optimally sized device for percutaneous PFO closure using the ASOC device.
Cite this article as: Venturini JM, Retzer EM, Estrada JR, Mediratta A, Friant J, Nathan S, Paul JD, Blair J, Lang RM, Shah AP. A Practical Scoring System to Select Optimally Sized Devices for Percutaneous Patent Foramen Ovale Closure. Structural Heart Disease 2016;2(5):217-223. DOI: 10.12945/j.jshd.2016.009.15
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Original Research Articles
Journal of Structural Heart Disease, October 2016, Volume 2, Issue 5:217-223
DOI: 10.12945/j.jshd.2016.009.15
A Practical Scoring System to Select Optimally Sized Devices for Percutaneous Patent Foramen Ovale Closure
Joseph M. Venturini, MD*, Elizabeth M. Retzer, MD, J. Raider Estrada, MD, Anuj Mediratta, MD, Janet Friant, MSN, Sandeep Nathan, MD, Jonathan D. Paul, MD, John Blair, MD, Roberto M. Lang, MD, Atman P. Shah, MD
Section of Cardiology, Department of Medicine, University of Chicago, Chicago, Illinois, USA
Abstract
Background: Patent foramen ovale (PFO) has been linked to cryptogenic stroke, and closure has been reported to improve clinical outcomes. However, there are no clear guidelines to direct device sizing. This study sought to use patient characteristics and echocardiographic findings to create a prediction score for device sizing.
Methods: This was a retrospective review of patients undergoing percutaneous PFO closure at our institution between July 2010 and December 2014. Demographic and clinical characteristics were recorded, and all pre- and intraprocedural echocardiography results were evaluated.
Results: Thirty-six patients underwent percutaneous PFO closure during the study period. All procedures were performed using an Amplatzer Septal Occluder “Cribriform” (ASOC) device in one of three disc diameters: 25, 30, or 35 mm. Closure was indicated for cryptogenic stroke/transient ischemic attack in 75% of cases. Every case (100%) was successful with durable shunt correction at the 6-month follow-up without complications of erosion or device embolization. The presence of atrial septal aneurysm (ASA) (p = 0.027) and PFO tunnel length >10 mm (p = 0.038) were independently associated with increased device size. A scoring system of 1 point for male sex, 1 point for ASA, and 1 point for PFO tunnel >10 mm long was associated with the size of closure device implanted (p = 0.006).
Conclusions: A simple scoring system may be used to select an optimally sized device for percutaneous PFO closure using the ASOC device.
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Cite this article as: Venturini JM, Retzer EM, Estrada JR, Mediratta A, Friant J, Nathan S, Paul JD, Blair J, Lang RM, Shah AP. A Practical Scoring System to Select Optimally Sized Devices for Percutaneous Patent Foramen Ovale Closure. Structural Heart Disease 2016;2(5):217-223. DOI: 10.12945/j.jshd.2016.009.15
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