Zhao Enfa, Liu Wenjuan, Zhang Yushun, Cheng Gesheng, Du Yajuan, He Lu, Wang Xingye, He Xumei
Department of Structural Heart Disease, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Medicine (Baltimore). 2017 Apr;96(14):e6572. doi: 10.1097/MD.0000000000006572.
Amplatzer occluder and Cardio-O-fix occluder are currently used in percutaneous closure of patent foramen ovale. However, there is still a lack of relevant reports comparison the differences between them. The aim of this study was to evaluate the short-term and mid-term safety and efficacy of the Cardi-O-fix occluder in preventing recurrent cerebrovascular events in patients with a patent foramen ovale (PFO).
We enrolled 246 patients (105 men) with a PFO from May 30, 2013 to March 30, 2015 in this single-center prospective study. All patients were treated by PFO interventional closure, with the Cardi-O-fix PFO occluder being used in 180 patients and the Amplatzer PFO occluder being utilized in the remaining 66 patients. After the procedure, we verified the safety and efficacy of different devices using contrast transthoracic echocardiography.
Neither recurrent stroke nor death was encountered during the follow-up of 12 months. Transient ischemic attack (TIA) was noted in 2 patients (1.1%) in the Cardi-O-fix PFO occluder group, and 1 patient suffered from TIA (1.5%) in the Amplatzer PFO occluder group. Among them, only 1 patient exhibited a small right to left shunt (RLS). There was no statistical difference in recurrent cerebral ischemic events. Three cases of paroxysmal atrial fibrillation were observed in the Cardi-O-fix PFO occluder group. One reverted spontaneously to sinus rhythm and the other 2 cases had pharmacologic conversion to sinus rhythm. One case of paroxysmal atrial fibrillation occurred in the Amplatzer group, which underwent pharmacologic conversion to sinus rhythm. There was no significant difference between the 2 groups regarding incidence of arrhythmia. No occluder translocation, erosion, pericardial effusion, and puncture site bleeding were observed in the 2 groups within 12 months of follow-up. The complete closure rates of the Cardi-O-fix and Amplatzer PFO occluder devices at the 12 months after the procedure were 73.9% and 63.6%, respectively, and the effective closure rates were 90.6% and 86.4%, respectively. There was no statistically significant difference in the complete closure rate and effective occlusion rate (P > 0.05) between the devices.
There was no significant difference in the short- and mid-term efficacy and safety between the Cardi-O-fix PFO occluder and Amplatzer PFO occluder. The efficacy and safety of the Cardi-O-fix occluder were comparable to those of the Amplatzer PFO occluder.
目前,Amplatzer封堵器和Cardio - O - fix封堵器用于经皮闭合卵圆孔未闭。然而,仍缺乏比较两者差异的相关报道。本研究旨在评估Cardio - O - fix封堵器预防卵圆孔未闭(PFO)患者复发性脑血管事件的短期和中期安全性及有效性。
在这项单中心前瞻性研究中,我们纳入了2013年5月30日至2015年3月30日期间的246例PFO患者(105例男性)。所有患者均接受PFO介入封堵治疗,其中180例患者使用Cardio - O - fix PFO封堵器,其余66例患者使用Amplatzer PFO封堵器。术后,我们通过经胸超声心动图造影验证不同器械的安全性和有效性。
在12个月的随访期间,未发生复发性卒中或死亡。Cardio - O - fix PFO封堵器组有2例患者(1.1%)发生短暂性脑缺血发作(TIA),Amplatzer PFO封堵器组有1例患者(1.5%)发生TIA。其中,仅1例患者出现少量右向左分流(RLS)。复发性脑缺血事件无统计学差异。Cardio - O - fix PFO封堵器组观察到3例阵发性心房颤动。1例自发恢复为窦性心律,另外2例经药物转复为窦性心律。Amplatzer组发生1例阵发性心房颤动,经药物转复为窦性心律。两组心律失常发生率无显著差异。随访12个月内,两组均未观察到封堵器移位、侵蚀、心包积液及穿刺部位出血。术后12个月时,Cardio - O - fix和Amplatzer PFO封堵器装置的完全闭合率分别为73.9%和63.6%,有效闭合率分别为90. %和86.4%。两种器械的完全闭合率和有效封堵率无统计学显著差异(P>0.05)。
Cardio - O - fix PFO封堵器和Amplatzer PFO封堵器在短期和中期的疗效及安全性方面无显著差异。Cardio - O - fix封堵器的疗效和安全性与Amplatzer PFO封堵器相当。