Paediatric Cardiology, University of Campania "Luigi Vanvitelli", Monaldi Hospital, Naples, Italy.
Paediatric Cardiology, University of Campania "Luigi Vanvitelli", Monaldi Hospital, Naples, Italy.
Int J Cardiol. 2019 Mar 15;279:47-50. doi: 10.1016/j.ijcard.2018.10.053. Epub 2018 Oct 16.
Patent foramen ovale (PFO) closure after a cryptogenic cerebral ischemic event is a routinely procedure. The most used device is Amplatzer™ PFO Occluder 25 mm, but PFOs with complex anatomy require larger device for closure. We compared Amplatzer™ Septal Occluder (ASO) device versus Amplatzer™ PFO Occluder 30 or 35 mm (A-PFO 30/35) about the safety of procedure and the presence of residual shunt during the follow-up.
From June 2002 to July 2016, 355 patients (pts) with PFO undergone closure at our institution. Among these ones, 70 pts (19.7%) had a PFO with complex anatomy and a single device with greater diameter was implanted. In these cases, the following devices were used: Gore® Septal Occluder (GSO) in 4 pts; ASO device in 33 pts (group I) and A-PFO 30/35 in 33 pts (group II). Patients treated with GSO device were excluded by our analysis.
Comparing group I and group II, there weren't complications during the procedures. Two patients of group II were lost at follow-up. At last follow-up, 1 pt of group I (3%) and 10 pts of group II (32.3%) had a residual shunt (p < 0.01). 7 of 10 pts of group II and the only 1 of group I with residual shunt underwent a complete closure by Amplatzer™ Vascular Plug (AVP) devices.
ASO devices and A-PFO 30/35 devices are both safe to close complex PFO; but A-PFO 30/35 is associated with a more incidence of residual shunt.
卵圆孔未闭（PFO）患者发生隐源性脑缺血事件后，通常会进行 PFO 封堵术。最常使用的装置是 Amplatzer™ PFO 封堵器 25mm，但解剖结构复杂的 PFO 需要更大的装置进行封堵。我们比较了 Amplatzer™ 隔瓣封堵器（ASO）与 Amplatzer™ PFO 封堵器 30 或 35mm（A-PFO 30/35）在手术安全性和随访期间残余分流方面的差异。
2002 年 6 月至 2016 年 7 月，我院共对 355 例 PFO 患者进行了封堵术。其中，70 例（19.7%）患者 PFO 解剖结构复杂，需要植入单个更大直径的装置。在这些情况下，使用了以下装置：戈尔®隔瓣封堵器（GSO）4 例；ASO 装置 33 例（I 组）和 A-PFO 30/35 装置 33 例（II 组）。我们的分析排除了接受 GSO 装置治疗的患者。
I 组和 II 组患者在手术过程中均无并发症。II 组中有 2 例患者在随访期间失访。在最后一次随访时，I 组有 1 例（3%）和 II 组有 10 例（32.3%）患者存在残余分流（p<0.01）。II 组中 10 例患者中有 7 例和 I 组中唯一的 1 例患者，通过 Amplatzer™ 血管塞（AVP）装置进行了完全封堵。
ASO 装置和 A-PFO 30/35 装置均可安全地封堵复杂的 PFO；但 A-PFO 30/35 与残余分流的发生率更高相关。
