Silvestry Frank E, Naseer Nauman, Wiegers Susan E, Hirshfeld John W, Herrmann Howard C
Cardiovascular Division, Department of Medicine Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
Catheter Cardiovasc Interv. 2008 Feb 15;71(3):383-7. doi: 10.1002/ccd.21364.
We tested the feasibility of percutaneous patent foramen ovale (PFO) closure utilizing the Amplatzer multifenestrated Cribriform atrial septal occluder device.
This device recently became available and may offer unique advantages for closure of PFO.
Nineteen consecutive patients who underwent closure of PFO with the Cribriform device for a variety of indications under intracardiac echocardiographic and fluoroscopic guidance were studied. The degree of shunting was quantified pre- and postprocedure by echocardiography using both Doppler and agitated saline administration. The results with this device were compared to the prior 19 patients who underwent closure with a CardioSeal device.
The mean age of patients was 52 years and 47% were female. Indications for closure were paradoxical embolism in 17 patients, and hypoxemia due to right to left shunt in 2 patients. The postprocedure bubble contrast study showed a marked improvement in right to left shunting with 13 patients (68%) demonstrating no shunt flow, 4 (21%) having trace shunting, and 2 (11%) mild shunting. There were no device-related complications. The mean procedure time was 28 +/- 10 min. In comparison to the CardioSeal device, a trend was apparent in terms of a greater percentage of patients with immediate closure with the Cribriform device, although a similar percentage of defect closure was seen at 6 months with both devices. Procedure time was shorter with the Cribriform device, related in part to the reduced need for balloon sizing.
This initial experience suggests a number of favorable characteristics of the Amplatzer Cribriform device for PFO closure.
我们测试了使用Amplatzer多孔筛状房间隔封堵器经皮闭合卵圆孔未闭（PFO）的可行性。
该装置最近开始应用，可能为PFO闭合提供独特优势。
对19例连续使用筛状装置在心脏超声心动图和荧光透视引导下因各种适应证进行PFO闭合的患者进行研究。术前和术后通过超声心动图使用多普勒和注射搅动生理盐水对分流程度进行量化。将该装置的结果与之前19例使用CardioSeal装置进行闭合的患者的结果进行比较。
患者的平均年龄为52岁，47%为女性。闭合的适应证为17例反常栓塞，2例因右向左分流导致的低氧血症。术后气泡造影研究显示右向左分流有显著改善，13例患者（68%）无分流，4例（21%）有微量分流，2例（11%）有轻度分流。无与装置相关的并发症。平均手术时间为28±10分钟。与CardioSeal装置相比，筛状装置立即闭合的患者百分比有更高的趋势，尽管两种装置在6个月时的缺损闭合百分比相似。筛状装置的手术时间更短，部分原因是对球囊大小测定的需求减少。
这一初步经验表明Amplatzer筛状装置在PFO闭合方面有许多有利特征。
