Percutaneous Closure of Patent Foramen Ovale – Single Centre Experience, Waikato Hospital

Abstract

Introduction: Patent foramen ovale (PFO) has been closed for multiple indications. Evidence to support these indications is continuing to mount. Aim: To evaluate the safety and effectiveness of percutaneous PFO closure at Waikato hospital. Methods: All information regarding the PFO closure including a six-month bubble study was gathered prospectively. The longer-term outcome was assessed by a telephone interview retrospectively. Results: 53 procedures were done on 50 patients. Indication for PFO closure was stroke(94%), peripheral embolisation(2%), barotrauma(2%) and postoperative desaturation(2%). Mean age was 45 years. Average waiting time for procedure was 76 ± 70days. Multiple devices were used to close the PFO (Amplatzer (60%), Primer (8%), Coherex (12%) and Occlutech (20%)). 58% PFO was closed using trans-oesophageal echo, 30%with intra cardiac echo and no ultrasound imaging in 12%. 98% of patients had a successful PFO closure with 6% closed at the second attempt and 1(2%) closed surgically. In 1 patient PFO was purposefully left unclosed. There was no perioperative vascular complication, major bleed or stroke. Bubble study at 6 months was done in 92% of patients. 87% had complete closure with 9% showing <5 bubbles crossing. During follow-up (3.7 ± 2.2 years), one non-device related death was observed. There were no strokes with 2(4%) patients had a TIA. There was no new onset AF, device migration, erosion or thrombus noted during the follow-up. 94% of patients were on no anticoagulants at the time of follow-up. Conclusion: PFO closure has been performed effectively with no short- or long-term adverse events. The recurrences of neurological events in the follow-up are very low.