Percutaneous patent foramen ovale closure: Outcomes with the Premere and Amplatzer devices

Bissessor, Naylin, Wong, Allison W., Hourigan, Lisa A., Jayasinghe, Rohan S., Scalia, Greg S., Burstow, Darryl J., Griffiths, Lyn R., Savage, Michael and Walters, Darren L. (2011) Percutaneous patent foramen ovale closure: Outcomes with the Premere and Amplatzer devices. Cardiovascular Revascularization Medicine, 12 3: 164-169. doi:10.1016/j.carrev.2010.06.001

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Author Bissessor, Naylin
Wong, Allison W.
Hourigan, Lisa A.
Jayasinghe, Rohan S.
Scalia, Greg S.
Burstow, Darryl J.
Griffiths, Lyn R.
Savage, Michael
Walters, Darren L.
Title Percutaneous patent foramen ovale closure: Outcomes with the Premere and Amplatzer devices
Journal name Cardiovascular Revascularization Medicine   Check publisher's open access policy
ISSN 1553-8389
Publication date 2011-05
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.carrev.2010.06.001
Volume 12
Issue 3
Start page 164
End page 169
Total pages 6
Place of publication Philadelphia, PA, U.S.A.
Publisher Elsevier
Collection year 2012
Language eng
Formatted abstract
Transcatheter closure of patent foramen ovale (PFO) has rapidly evolved as the preferred management strategy for the prevention of recurrent cerebrovascular events in patients with cryptogenic stroke and presumed paradoxical embolus. There is limited outcome data in patients treated with this therapy particularly for the newer devices.

Data from medical records, catheter, and echocardiography databases on 70 PFO procedures performed was collected prospectively.

The cohort consisted of 70 patients (mean age 43.6 years, range 19 to 77 years), of whom 51% were male. The indications for closure were cryptogenic cerebrovascular accident (CVA) or transient ischemic attack (TIA) in 64 (91%) and peripheral emboli in two (2.8%) patients and cryptogenic ST-elevation myocardial infarction in one (1.4%), refractory migraine in one (1.4%), decompression sickness in one (1.4%), and orthodeoxia in one (1.4%) patient, respectively. All patients had demonstrated right-to-left shunting on bubble study. The procedures were guided by intracardiac echocardiography in 53%, transesophageal echocardiography in 39%, and the remainder by transthoracic echo alone. Devices used were the Amplatzer PFO Occluder (AGA Medical) (sizes 18–35 mm) in 49 (70%) and the Premere device (St. Jude Medical) in 21 (30%). In-hospital complications consisted of one significant groin hematoma with skin infection. Echocardiographic follow-up at 6 months revealed that most patients had no or trivial residual shunt (98.6%), while one patient (1.4%) had a mild residual shunt. At a median of 11 months' follow-up (range 1 month to 4.3 years), no patients (0%) experienced further CVA/TIAs or paradoxical embolic events during follow-up.

PFO causing presumed paradoxical embolism can be closed percutaneously with a low rate of significant residual shunting and very few complications. Recurrent index events are uncommon at medium-term (up to 4 years) follow-up.
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Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2012 Collection
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Created: Thu, 03 Nov 2011, 14:41:59 EST by Matthew Lamb on behalf of School of Medicine