{"id":13152,"date":"2023-03-22T00:00:00","date_gmt":"2023-03-22T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/publications\/journal-articles\/outcomes-of-patent-foramen-ovale-transcatheter-closure-should-a-short-aortic-rim-preclude-closure\/"},"modified":"2023-07-21T15:41:45","modified_gmt":"2023-07-21T19:41:45","slug":"outcomes-of-patent-foramen-ovale-transcatheter-closure-should-a-short-aortic-rim-preclude-closure","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/outcomes-of-patent-foramen-ovale-transcatheter-closure-should-a-short-aortic-rim-preclude-closure\/","title":{"rendered":"Outcomes of patent foramen ovale transcatheter closure: Should a short aortic rim preclude closure?"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 The risk of erosion of an atrial septal closure device, in particular the Amplatzer Septal Occluder, has been described as higher in patients with a short aortic rim. Similar concern has been applied to patent foramen ovale (PFO) closure devices, but there are only rare reported cases of erosion. It may be that smaller devices are chosen due to fear of device erosion in PFO patients when this is not necessarily an issue.<\/p>\n<p><strong>Objectives<\/strong> \u2014 We aimed to assess outcomes after PFO closure with the Amplatzer PFO device in patients with a short (&lt;9 mm) aortic rim.<\/p>\n<p><strong>Methods<\/strong> \u2014 We performed a retrospective analysis of PFO closure for any indication, between 2006 and 2017 at a quaternary center. Preprocedural transesophageal echocardiographic parameters including the aortic rim were remeasured. Long-term outcomes were obtained by linkage to provincial administrative databases.<\/p>\n<p><strong>Results<\/strong> \u2014 Over the study period, 324 patients underwent PFO closure with the Amplatzer PFO device, with a mean age of 49.8 years; 61% had a short aortic rim (&lt;9 mm). The most common indication was cryptogenic stroke (72%); those with longer aortic distance were more likely to have a non-stroke indication for closure, diabetes (15% vs 6.5%, <em>P<\/em> = 0.04), and heart failure (15.7% vs 4%, <em>P<\/em> &lt; 0.001). Over a median 7 years of follow-up, there were no cases of device erosion or embolization requiring cardiac surgery.<\/p>\n<p><strong>Conclusions<\/strong> \u2014 In a large cohort with long-term administrative follow-up (1,394 patient-years), implantation of an Amplatzer PFO device was performed safely even in patients with a short aortic rim.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 The risk of erosion of an atrial septal closure device, in particular the Amplatzer Septal Occluder, has been described as higher in patients with a short aortic rim. Similar concern has been applied to patent foramen ovale (PFO) closure devices, but there are only rare reported cases of erosion. It may be that [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[40],"migration-helper-qa-sample-set":[],"class_list":["post-13152","journal_article","type-journal_article","status-publish","hentry","topic-cardiovascular-disease"],"acf":{"citation":"Schmidt ACS, Abrahamyan L, Muthuppalaniappan A, Romero RG, Ephrem G, Everett K, Lee DS, Osten M, Benson LN, Horlick EM. <em>JACC Adv<\/em>. 2023; Mar 22 [Epub ahead of print].","source_url":"https:\/\/www.jacc.org\/doi\/10.1016\/j.jacadv.2023.100257","ices_scientist":[1290,17632],"site":[6733],"research_program":[6742],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"C1707CC7-1AB0-493B-B40E-216E60773549","sitecore_item_name":"Outcomes-of-patent-foramen-ovale-transcatheter-closure","sitecore_field_values":"{\r\n  \"Title\": \"Outcomes of patent foramen ovale transcatheter closure: Should a short aortic rim preclude closure?\",\r\n  \"Short title\": \"Outcomes of patent foramen ovale\",\r\n  \"Summary\": \"The study aimed to assess outcomes after patent foramen ovale closure with the Amplatzer patent foramen ovale device in patients with a short (<9 mm) aortic rim.\",\r\n  \"Citation\": \"<p>Schmidt ACS, Abrahamyan L, Muthuppalaniappan A, Romero RG, Ephrem G, Everett K, Lee DS, Osten M, Benson LN, Horlick EM. <em>JACC Adv<\/em>. 2023; Mar 22 [Epub ahead of print]. DOI: <a href=\"https:\/\/doi.org\/10.1016\/j.jacadv.2023.100257\" title=\"opens external link\">https:\/\/doi.org\/10.1016\/j.jacadv.2023.100257<\/a><\/p>\",\r\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; The risk of erosion of an atrial septal closure device, in particular the Amplatzer Septal Occluder, has been described as higher in patients with a short aortic rim. Similar concern has been applied to patent foramen ovale (PFO) closure devices, but there are only rare reported cases of erosion. It may be that smaller devices are chosen due to fear of device erosion in PFO patients when this is not necessarily an issue.<\/p>n<p><strong>Objectives<\/strong> &mdash; We aimed to assess outcomes after PFO closure with the Amplatzer PFO device in patients with a short (&lt;9 mm) aortic rim.<\/p>n<p><strong>Methods<\/strong> &mdash; We performed a retrospective analysis of PFO closure for any indication, between 2006 and 2017 at a quaternary center. Preprocedural transesophageal echocardiographic parameters including the aortic rim were remeasured. Long-term outcomes were obtained by linkage to provincial administrative databases.<\/p>n<p><strong>Results<\/strong> &mdash; Over the study period, 324 patients underwent PFO closure with the Amplatzer PFO device, with a mean age of 49.8 years; 61% had a short aortic rim (&lt;9 mm). The most common indication was cryptogenic stroke (72%); those with longer aortic distance were more likely to have a non-stroke indication for closure, diabetes (15% vs 6.5%, <em>P<\/em> = 0.04), and heart failure (15.7% vs 4%, <em>P<\/em> &lt; 0.001). Over a median 7 years of follow-up, there were no cases of device erosion or embolization requiring cardiac surgery.<\/p>n<p><strong>Conclusions<\/strong> &mdash; In a large cohort with long-term administrative follow-up (1,394 patient-years), implantation of an Amplatzer PFO device was performed safely even in patients with a short aortic rim.<\/p>n<p><a href=\"https:\/\/www.jacc.org\/doi\/10.1016\/j.jacadv.2023.100257\" title=\"opens external link\">View full text<\/a><\/p>\",\r\n  \"ICES Scientists\": \"{CEEE13AD-C7DE-455F-ACF8-AAD7D27BB178}\",\r\n  \"Posted Date\": \"20230322T000000\",\r\n  \"Show on Publications Landing Page\": \"1\"\r\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2023\/March\/Outcomes-of-patent-foramen-ovale-transcatheter-closure"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Outcomes of patent foramen ovale transcatheter closure: 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