Musto Carmine, Cifarelli Alberta, Pandolfi Claudia, De Felice Francesco, Fiorilli Rosario, Caferri Giorgia, Violini Roberto
Interventional Cardiology Unit, S. Camillo Hospital, Circonvallazione Gianicolense 87, 00151 Rome, Italy.
J Invasive Cardiol. 2009 Jun;21(6):290-3.
We sought to evaluate the short- and longterm outcomes of Amplatzer Multi-Fenestrated Septal Occluder Cribriform (AMF) device use in the percutaneous closure of patent foramen ovale (PFO) associated with atrial septal aneurysm (ASA).
Since patients with PFO, associated with ASA, are at higher risk of embolic events (EE), the AMF device might offer advantages in this subgroup of patients.
Overall, 38 consecutive patients, with both PFO and ASA, underwent percutaneous closure of the defect with the AMF device, and the results were compared to those in 38 patients with PFO and ASA treated with the Amplatzer PFO device (APO). Death due to embolism, stroke or transient ischemic attack (TIA) were considered recurrent EE. Pre- and post-intervention shunting and 6-month residual shunting were evaluated echocardiographically with intravenous contrast injection.
The procedure was successfully completed in all patients in both groups. No procedure-related complications were observed during hospitalization. Immediate closure was achieved in all patients in the AMF group, whereas 3 patients in the APO group showed a small residual shunt. Residual shunting was observed at 6 months in 2 patients in the APO group. No recurrence of EE was recorded in the AMF group. Recurrent TIA was observed in 3 patients in the APO group; 2/3 patients had a small residual shunt following the procedure and at 6-month follow up.
The AMF device might offer advantages in terms of rate of EE recurrence or residual shunt compared to the APO device in PFO patients associated with ASA.
我们旨在评估使用Amplatzer多孔筛状房间隔封堵器(AMF)经皮闭合与房间隔瘤(ASA)相关的卵圆孔未闭(PFO)的短期和长期结果。
由于伴有ASA的PFO患者发生栓塞事件(EE)的风险较高,AMF装置可能在这一亚组患者中具有优势。
总体而言,38例同时患有PFO和ASA的连续患者接受了使用AMF装置经皮封堵缺损的治疗,并将结果与38例接受Amplatzer卵圆孔未闭封堵器(APO)治疗的PFO和ASA患者进行比较。因栓塞、中风或短暂性脑缺血发作(TIA)导致的死亡被视为复发性EE。在静脉注射造影剂后,通过超声心动图评估干预前后的分流情况以及6个月时的残余分流情况。
两组所有患者的手术均成功完成。住院期间未观察到与手术相关的并发症。AMF组所有患者均实现即刻封堵,而APO组有3例患者显示有小的残余分流。APO组有2例患者在6个月时观察到残余分流。AMF组未记录到EE复发。APO组有3例患者发生复发性TIA;其中2/3的患者在手术后及6个月随访时有小的残余分流。
与APO装置相比,在伴有ASA的PFO患者中,AMF装置在EE复发率或残余分流方面可能具有优势。