Van den Branden B J L, Post M C, Jaarsma W, ten Berg J M, Suttorp M J
Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
Catheter Cardiovasc Interv. 2009 Aug 1;74(2):286-90. doi: 10.1002/ccd.21998.
Permanent implants for closure of a patent foramen ovale (PFO) have a number of possible disadvantages including erosions, thrombus formation, and allergic reactions. The incidence of adverse events may be lower using a bioabsorbable device.
To evaluate the short-term safety and efficacy of a new bioabsorbable closure device.
All 35 consecutive patients (21 female, mean age 47.9 +/- 10.8 years), who underwent a percutaneous PFO closure between November 2007 and July 2008, were included. All complications were reported. The efficacy was based on the residual shunting the day after implant and at 1 month follow-up and was graded as minimal, moderate, or severe, using contrast transthoracic echocardiography with the Valsalva manoeuvre.
The only in-hospital complication was a surgical device retrieval from the femoral vein. Four patients developed a minimal inguinal haematoma. One day after closure, residual shunting was present in 56% of the patients (minimal 27%, moderate 23% and severe 6%). At 1 month follow-up (n = 33), one patient developed a transient neurological deficit and three patients suffered from paroxysmal atrial fibrillation. A residual shunt at 1 month was present in 45% of the patients (minimal 30%, moderate 12%, and severe 3%).
Percutaneous PFO closure using the bioabsorbable closure device seems to be safe. However, a high rate of residual shunting is present at 1 month follow-up. Long-term follow-up data are necessary to evaluate the efficacy and safety of this device.
用于闭合卵圆孔未闭(PFO)的永久性植入物存在一些潜在缺点,包括侵蚀、血栓形成和过敏反应。使用生物可吸收装置时不良事件的发生率可能较低。
评估一种新型生物可吸收闭合装置的短期安全性和有效性。
纳入2007年11月至2008年7月间连续接受经皮PFO闭合术的所有35例患者(21例女性,平均年龄47.9±10.8岁)。报告所有并发症。疗效基于植入后次日及1个月随访时的残余分流情况,采用Valsalva动作经胸超声心动图检查,并分为微量、中度或重度。
唯一的院内并发症是从股静脉取出手术装置。4例患者出现微量腹股沟血肿。闭合术后1天,56%的患者存在残余分流(微量27%,中度23%,重度6%)。在1个月随访时(n = 33),1例患者出现短暂性神经功能缺损,3例患者发生阵发性心房颤动。1个月时45%的患者存在残余分流(微量30%,中度12%,重度3%)。
使用生物可吸收闭合装置经皮闭合PFO似乎是安全的。然而,在1个月随访时存在较高比例的残余分流。需要长期随访数据来评估该装置的有效性和安全性。