SPC365

Percutaneous Patent Foramen Ovale Closure: 18 years’ Experience in a Tertiary Centre

Session: Posters (Sessão 4 - Écran 7) - Intervenção Cardíaca Coronária e Estrutural 2 - Foco na Doença Estrutural Não Valvular
Speaker: Carolina Saleiro

Congress: CPC 2022
Topic: H. Interventional Cardiology and Cardiovascular Surgery
Theme: 25. Interventional Cardiology
Subtheme: 25.4 Interventional Cardiology - Other
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Carolina Saleiro; Sara Matos; Telma Alves; Diana de Campos; Manuel Oliveira-Santos; Fernando Silva; Gustavo Santo; João Sargento Freitas; Luís Paiva; Marco Costa; Lino Gonçalves

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Background: </span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Patent foramen ovale (PFO) is implicated in several medical conditions. Percutaneous closure is the standard therapy when a high risk PFO is considered to have an important pathogenic role. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Aim: </span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">To assess the feasibility and safety of PFO percutaneous closure.<strong> </strong></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Methods: </span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">336 consecutive patients who underwent PFO closure between 06/2003 and 11/2021 were included in the analysis. Demographic, imagological, and procedural data were collected. Short-term follow-up was done during hospitalization and long-term at 12 [6-29] months.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Results: </span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Mean age was 47<span style="color:black">&plusmn;11years old, with 55.7% female patients. </span>Comorbidity with CV risk factors was low: 27% HTN, 25.9% dyslipidaemia; 16.3% overweight/obesity; 15.7% active smoking; 6.2% DM and 6.5% SOAS. Comorbidity with headache was present in almost a quarter. 4,5% of the patients had history of venous embolism and 16,1% confirmed prothrombotic state. The main indication for closure was previous stroke/transitory ischemic attack (91,1%). Mean RopE Score was 6.8<span style="color:black">&plusmn;1.6; mean PFO risk characteristics was 4&plusmn;2 (aneurismatic septum 41.8%, moderate shunt 14.5%; severe shunt 68.5%; septum hypermobility 41.1%; long tunnel 73.6%; Chiari web 0.9%; large PFO 62.3%). Amplatzer device was employed more frequently (70.6%) followed by Premere (14.8%). The procedure was guided both by fluoroscopy and intracardiac echocardiography. Mean fluoroscopy time was 7.4&plusmn;4.6 minutes and effective radiation dosage 172&plusmn;182mGy. &nbsp;</span>Procedural complication rate was 1.2%: 1 patient had device embolization resolved percutaneously; 3 patients had vascular complications (1 treated conservatively; 1 fistula treated percutaneously and 1 pseudoaneurysm with need for surgery). No perforations, device thrombosis or periprocedural deaths were reported. Periprocedural atrial arrythmias occurred in 0.7% of the patients. One-month after the procedure, peri device shunt was present in 3.6% of the cases, six-month evaluation with agitated saline showed patent shunt in 7.7% that decreased to 3.6% at one-year. During long-term follow-up, 1.2% of the patients had atrial fibrillation; stroke recurrence rate was 1.5% and all-cause mortality was 1.5%. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Conclusion: </span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Our centre experience shows that percutaneous PFO closure is safe and feasible with a minimal rate of periprocedural complication. Stroke recurrence and atrial fibrillation rates were low during the follow-up. </span></span></span></span></p>