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Ghanem R, Barra C, Shapeton AD, Musuku SR. Improving Safety of Transseptal Puncture for Patients with Abnormal Cardiac Anatomy. J Cardiothorac Vasc Anesth 2024:S1053-0770(24)00448-8. [PMID: 39069385 DOI: 10.1053/j.jvca.2024.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/02/2024] [Accepted: 07/04/2024] [Indexed: 07/30/2024]
Affiliation(s)
| | | | - Alexander D Shapeton
- Veterans Affairs Boston Healthcare System, Department of Anesthesia, Critical Care and Pain Medicine; Tufts University School of Medicine, Boston, MA
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Hauguel-Moreau M, Guedeney P, Dauphin C, Auffret V, Marijon E, Aldebert P, Clerc JM, Beygui F, Elbaz M, Khalil WA, Da Costa A, Macia JC, Elhadad S, Cayla G, Brugier D, Silvain J, Hammoudi N, Duthoit G, Vicaut E, Montalescot G. Flecainide to prevent atrial arrhythmia after patent foramen ovale closure, Rationale and design of the randomized AFLOAT study. EUROPEAN HEART JOURNAL. CARDIOVASCULAR PHARMACOTHERAPY 2024; 10:184-189. [PMID: 38216511 DOI: 10.1093/ehjcvp/pvad100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/25/2023] [Accepted: 01/09/2024] [Indexed: 01/14/2024]
Abstract
INTRODUCTION Atrial arrhythmia is the most common complication of patent foramen ovale (PFO) closure. The real incidence of post-PFO closure atrial arrhytmia and whether this complication can be prevented is unknown. METHODS/DESIGN The Assessment of Flecainide to Lower the PFO closure risk of Atrial fibrillation or Tachycardia (AFLOAT) trial is a prospective, national, multicentre, randomized, open-label, superiority trial with a blind evaluation of all the endpoints (PROBE design). A total of 186 patients are randomized in a 1:1:1 ratio immediately after PFO closure to receive Flecainide (150 mg per day in a single sustained-release (SR) dose) for 6 months (Group 1), Flecainide (150 mg per day in a single SR dose) for 3 months (Group 2), or no additional treatment (standard of care) for 6 months (Group 3). The primary endpoint is the percentage of patients with at least one episode of symptomatic or asymptomatic atrial arrhythmia episode (≥30 s) recorded within 3 months after PFO closure on long-term monitoring with an insertable cardiac monitor. Whether 3 months of treatment is sufficient compared to 6 months will be analysed as a secondary objective of the study. CONCLUSION AFLOAT is the first trial to test the hypothesis that a short treatment with oral Flecainide can prevent the new-onset of atrial arrhythmia after PFO closure. CLINICAL TRIAL REGISTRATION NCT05213104 (clinicaltrials.gov).
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Affiliation(s)
- Marie Hauguel-Moreau
- Université de Versailles-Saint Quentin, INSERM U1018, CESP, ACTION Study Group, Department of Cardiology, Ambroise Paré Hospital (AP-HP), 92100 Boulogne, France
| | - Paul Guedeney
- Sorbonne Université, ACTION Study Group, INSERM UMRS1166, ICAN-Institute of CardioMetabolism and Nutrition, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (AP-HP), 75013 Paris, France
| | - Claire Dauphin
- Department of Cardiology and Cardiovascular Diseases, Clermont-Ferrand University Hospital, 63000 Clermont-Ferrand, France
| | - Vincent Auffret
- University Hospital Pontchaillou, Cardiology and Vascular Disease Department, CIC-IT 804, Rennes 1 University, Signal and Image Processing Laboratory (LTSI), INSERM U1099, 35000 Rennes, France
| | - Eloi Marijon
- Cardiology Department, European Georges Pompidou Hospital, 75015 Paris, France
| | | | - Jean-Michel Clerc
- Cardiology Department, Centre Hospitalier Universitaire de Tours, 37000 Tours, France
| | - Farzin Beygui
- CHU de la Côte de Nacre, Département de Cardiologie, 14000 Caen, France
| | - Meyer Elbaz
- Department of Cardiology, Institute CARDIOMET, CHU-Toulouse, 31000 Toulouse, France
| | - Wissam Abi Khalil
- Institut Mitovasc, University of Angers, UMR CNRS 6015-INSERMU1083, 49000 Angers, France
| | - Antoine Da Costa
- Service de cardiologie, Hôpital Nord, Université Jean-Monnet, CHU de Saint-Étienne, 42000 Saint-Étienne, France
| | - Jean-Christophe Macia
- Montpellier University Hospital, UFR de Médecine, Université Montpellier 1, Department of Cardiology, 371, avenue du Doyen-Gaston-Giraud, 34000 Montpellier 5, France
| | - Simon Elhadad
- Service de Cardiologie, Centre hospitalier de Marne-la-Vallée, 77600 Jossigny, France
| | - Guillaume Cayla
- Cardiology department, Nimes University Hospital, Montpellier University, ACTION group, 34000 Nimes, France
| | - Delphine Brugier
- Sorbonne Université, ACTION Study Group, INSERM UMRS1166, ICAN-Institute of CardioMetabolism and Nutrition, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (AP-HP), 75013 Paris, France
| | - Johanne Silvain
- Sorbonne Université, ACTION Study Group, INSERM UMRS1166, ICAN-Institute of CardioMetabolism and Nutrition, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (AP-HP), 75013 Paris, France
| | - Nadjib Hammoudi
- Sorbonne Université, ACTION Study Group, INSERM UMRS1166, ICAN-Institute of CardioMetabolism and Nutrition, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (AP-HP), 75013 Paris, France
| | - Guillaume Duthoit
- Sorbonne Université, ACTION Study Group, INSERM UMRS1166, ICAN-Institute of CardioMetabolism and Nutrition, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (AP-HP), 75013 Paris, France
| | - Eric Vicaut
- ACTION Study Group, Unité de Recherche Clinique, Hopital Lariboisière, (APHP), Université Paris-Diderot Paris 7, 75010 Paris, France
| | - Gilles Montalescot
- Sorbonne Université, ACTION Study Group, INSERM UMRS1166, ICAN-Institute of CardioMetabolism and Nutrition, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (AP-HP), 75013 Paris, France
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Kneihsl M, Horner S, Hatab I, Schöngrundner N, Kramer D, Toth-Gayor G, Grangl G, Wünsch G, Fandler-Höfler S, Haidegger M, Berger N, Veeranki S, Fischer U, Enzinger C, Gattringer T. Long-term risk of recurrent cerebrovascular events after patent foramen ovale closure: Results from a real-world stroke cohort. Eur Stroke J 2023; 8:1021-1029. [PMID: 37658692 PMCID: PMC10683717 DOI: 10.1177/23969873231197564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/11/2023] [Indexed: 09/03/2023] Open
Abstract
INTRODUCTION Patent foramen ovale (PFO)-closure is recommended for stroke prevention in selected patients with suspected PFO-associated stroke. However, studies on cerebrovascular event recurrence after PFO-closure are limited by relatively short follow-up periods and information on the underlying aetiology of recurrent events is scarce. PATIENTS AND METHODS All consecutive patients with a cerebral ischaemic event and PFO-closure at the University Hospital Graz were prospectively identified from 2004 to 2021. Indication for PFO-closure was based on a neurological-cardiological PFO board decision. Patients underwent standardized clinical and echocardiographic follow-up 6 months after PFO-closure. Recurrent cerebrovascular events were assessed via electronical health records. RESULTS PFO-closure was performed in 515 patients (median age: 49 years; Amplatzer PFO occluder: 42%). Over a median follow-up of 11 years (range: 2-18 years, 5141 total patient-years), recurrent ischaemic cerebrovascular events were observed in 34 patients (ischaemic stroke: n = 22, TIA: n = 12) and associated with age, hyperlipidaemia and smoking in multivariable analysis (p < 0.05 each). Large artery atherosclerosis and small vessel disease were the most frequent aetiologies of recurrent stroke/TIA (27% and 24% respectively), and only two events were related to atrial fibrillation (AF). Recurrent ischaemic cerebrovascular event rates and incident AF were comparable in patients treated with different PFO occluders (p > 0.1). DISCUSSION AND CONCLUSION In this long-term follow-up-study of patients with a cerebral ischaemic event who had received PFO-closure with different devices, rates of recurrent stroke/TIA were low and largely related to large artery atherosclerosis and small vessel disease. Thorough vascular risk factor control seems crucial for secondary stroke prevention in patients treated for PFO-related stroke.
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Affiliation(s)
- Markus Kneihsl
- Department of Neurology, Medical University of Graz, Graz, Austria
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Susanna Horner
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Isra Hatab
- Department of Neurology, Medical University of Graz, Graz, Austria
| | | | - Diether Kramer
- Department of Information and Process Management, Steiermärkische Krankenanstaltengesellschaft m.b.H. (KAGes), Graz, Austria
| | - Gabor Toth-Gayor
- Division of Cardiology, Department of Internal Medicine, Medical University Graz, Graz, Austria
| | - Gernot Grangl
- Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Graz, Austria
| | - Gerit Wünsch
- Institute of Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | | | | | - Natalie Berger
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Sai Veeranki
- Department of Information and Process Management, Steiermärkische Krankenanstaltengesellschaft m.b.H. (KAGes), Graz, Austria
| | - Urs Fischer
- Department of Neurology, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Thomas Gattringer
- Department of Neurology, Medical University of Graz, Graz, Austria
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
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Hutayanon P, Muengtaweepongsa S. The Role of Transcranial Doppler in Detecting Patent Foramen Ovale. JOURNAL FOR VASCULAR ULTRASOUND 2023; 47:33-39. [DOI: 10.1177/15443167221108512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
Air embolic signals detected in the intracranial arteries using transcranial Doppler after intravenous injection of agitated saline bubbles indicate right-to-left cardiac shunting. They prove that emboli from venous sites can bypass the lungs and flow to the intracranial arteries. The Valsalva maneuver immediately after an intravenous injection of agitated saline bubbles helps the air bubbles pass through the shunt. If the air embolic signal appears in the intracranial arteries without the Valsalva maneuver, the shunting is highly significant to the etiology of embolism. Transcranial Doppler to detect air embolic signals after intravenous injection of agitated saline bubbles may not be mandatory to diagnose and treat patent foramen ovale; however, as with echocardiography, transcranial Doppler is considered a noninvasive, convenient, and low-cost investigation. The test should be helpful to confirm the significance of the corresponding patent foramen ovale.
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5
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Rigatelli G, Zuin M, Rodinò G, Marchese G, Pasquetto G. Recent advances in catheter devices for patent foramen ovale closure. Expert Rev Med Devices 2023; 20:29-34. [PMID: 36656563 DOI: 10.1080/17434440.2023.2170782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Over the last 5 years, the armamentarium of the interventional cardiologist dealing with percutaneous closure of patent foramen ovale (PFO) has been enriched by some novel devices and further improvements of existing ones that have or promise to increase the safety and effective closure rate of PFO patients. AREAS COVERED This review presents and discusses recent advancements in device design and composition from both technical and clinical perspectives. EXPERT OPINION Device technology is continuously evolving. The recent modification of delivery system, device hooking, and composition, as well as the advent of new bioabsorbable materials, is promising to make percutaneous PFO closure devices safer. The search for more effectiveness with possibly less metal behind is still ongoing.
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Affiliation(s)
- Gianluca Rigatelli
- Interventional Cardiology Unit, Division of Cardiology, Ospedali Riuniti Padova Sud, Padova, Italy
| | - Marco Zuin
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Giulio Rodinò
- Interventional Cardiology Unit, Division of Cardiology, Ospedali Riuniti Padova Sud, Padova, Italy
| | - Giuseppe Marchese
- Interventional Cardiology Unit, Division of Cardiology, Ospedali Riuniti Padova Sud, Padova, Italy
| | - Giampaolo Pasquetto
- Interventional Cardiology Unit, Division of Cardiology, Ospedali Riuniti Padova Sud, Padova, Italy
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6
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Hagemeyer D, Ali FM, Ong G, Fam NP. The Role of Intracardiac Echocardiography in Percutaneous Tricuspid Intervention: A New ICE Age. Interv Cardiol Clin 2021; 11:103-112. [PMID: 34838293 DOI: 10.1016/j.iccl.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The prevalence of severe tricuspid regurgitation in older patients is high, and the clinical relevance is perceived more and more in recent years. Many of these patients are not suitable for surgery because of their age and comorbidities. Therefore, a variety of percutaneous interventions have been developed to address this unmet need. Procedural success strongly depends on adequate imaging during the intervention. Although transesophageal echocardiography is the standard of care, imaging may be limited due to anatomic factors and adverse acoustic shadowing. In this review, we discuss the current and future role of intracardiac echocardiography in tricuspid valve interventions.
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Affiliation(s)
- Daniel Hagemeyer
- Division of Cardiology, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada. https://twitter.com/DanielHagemeyer
| | - Faeez M Ali
- Division of Cardiology, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada; Waikato Hospital, 183 Pembroke Street, Hamilton 3204, New Zealand
| | - Geraldine Ong
- Division of Cardiology, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada
| | - Neil P Fam
- Division of Cardiology, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada.
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7
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HAN KN, MA XT, YANG SW, ZHOU YJ. Intracardiac echocardiography in the diagnosis and closure of patent foramen ovale. J Geriatr Cardiol 2021; 18:697-701. [PMID: 34659375 PMCID: PMC8501384 DOI: 10.11909/j.issn.1671-5411.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Kang-Ning HAN
- Beijing Anzhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Disease; The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education; Beijing, China
| | - Xiao-Teng MA
- Beijing Anzhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Disease; The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education; Beijing, China
| | - Shi-Wei YANG
- Beijing Anzhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Disease; The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education; Beijing, China
| | - Yu-Jie ZHOU
- Beijing Anzhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Disease; The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education; Beijing, China
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8
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Thrombus straddling a patent foramen ovale: Also a myocardial infarction matter? Int J Cardiol 2021; 340:24-25. [PMID: 34375708 DOI: 10.1016/j.ijcard.2021.07.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 07/30/2021] [Indexed: 11/22/2022]
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9
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Chen JZJ, Thijs VN. Atrial Fibrillation Following Patent Foramen Ovale Closure: Systematic Review and Meta-Analysis of Observational Studies and Clinical Trials. Stroke 2021; 52:1653-1661. [PMID: 33611943 DOI: 10.1161/strokeaha.120.030293] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Jessie Ze-Jun Chen
- Department of Neurology, Austin Health, Heidelberg, Victoria, Australia (J.Z.-J.C., V.N.T.)
| | - Vincent N Thijs
- Department of Neurology, Austin Health, Heidelberg, Victoria, Australia (J.Z.-J.C., V.N.T.).,Stroke Theme, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Victoria, Australia (V.N.T.)
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10
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Mathew A, Taylor D. Fluoroscopy-Only Guided Patent Foramen Ovale Device Closure: Will It Cut Ice With the Interventionalist Community? Can J Cardiol 2020; 36:1569-1571. [PMID: 32574604 DOI: 10.1016/j.cjca.2020.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/24/2020] [Accepted: 03/24/2020] [Indexed: 01/10/2023] Open
Affiliation(s)
- Anoop Mathew
- Division of Cardiology, University of Alberta Hospital, Edmonton, Alberta, Canada
| | - Dylan Taylor
- Division of Cardiology, University of Alberta Hospital, Edmonton, Alberta, Canada.
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Kumar P, Rusheen J, Tobis JM. A comparison of methods to determine patent foramen ovale size. Catheter Cardiovasc Interv 2019; 96:E621-E629. [DOI: 10.1002/ccd.28665] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 12/07/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Preetham Kumar
- Division of Cardiology, Department of Medicine University of California Los Angeles California
| | - Joshua Rusheen
- Division of Cardiology, Department of Medicine University of California Los Angeles California
| | - Jonathan M. Tobis
- Division of Cardiology, Department of Medicine University of California Los Angeles California
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12
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Zuin M, Rigatelli G, Rigatelli A, Ronco F, Conte L, Roncon L, Mazza A. Correlations between serum homocysteine levels and RoPE score in patients with patent foramen ovale. Heart Vessels 2019; 35:705-711. [DOI: 10.1007/s00380-019-01528-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/18/2019] [Indexed: 10/25/2022]
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13
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Patent foramen ovale-related complications in left ventricular assist device patients: a reappraisal for cardiovascular professionals. J Artif Organs 2019; 23:98-104. [DOI: 10.1007/s10047-019-01128-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/21/2019] [Indexed: 10/26/2022]
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Rigatelli G, Zuin M, Adami A, Aggio S, Lanza D, d’Elia K, Braggion G, Russo M, Mazza A, Roncon L. Left atrial enlargement as a maker of significant high-risk patent foramen ovale. Int J Cardiovasc Imaging 2019; 35:2049-2056. [DOI: 10.1007/s10554-019-01666-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 07/11/2019] [Indexed: 02/05/2023]
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Ribeiro JM, Teixeira R, Puga L, Costa M, Gonçalves L. Comparison of intracardiac and transoesophageal echocardiography for guidance of percutaneous left atrial appendage occlusion: A meta-analysis. Echocardiography 2019; 36:1330-1337. [DOI: 10.1111/echo.14415] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 04/23/2019] [Accepted: 05/31/2019] [Indexed: 02/05/2023] Open
Affiliation(s)
- Joana Maria Ribeiro
- Serviço de Cardiologia; Centro Hospilatar e Universitário de Coimbra; Coimbra Portugal
| | - Rogério Teixeira
- Serviço de Cardiologia; Centro Hospilatar e Universitário de Coimbra; Coimbra Portugal
- Faculdade de Medicina da Universidade de Coimbra; Coimbra Portugal
| | - Luís Puga
- Serviço de Cardiologia; Centro Hospilatar e Universitário de Coimbra; Coimbra Portugal
| | - Marco Costa
- Serviço de Cardiologia; Centro Hospilatar e Universitário de Coimbra; Coimbra Portugal
| | - Lino Gonçalves
- Serviço de Cardiologia; Centro Hospilatar e Universitário de Coimbra; Coimbra Portugal
- Faculdade de Medicina da Universidade de Coimbra; Coimbra Portugal
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[Postoperative complications after major lung resection]. Rev Mal Respir 2019; 36:720-737. [PMID: 31208887 DOI: 10.1016/j.rmr.2018.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 09/08/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The advent of the minimally invasive techniques has allowed an expansion of the indications for thoracic surgery, particularly in older patients and those with more comorbidities. However, the rate of postoperative complications has remained stable. STATE OF THE ART Postoperative complications are defined as any variation from the normal course. They occur in 30% but majority of them are minor. The 30-day mortality rate for lung resection varies range between 2 % and 3% in the literature. Complications can be classified as: (1) early (occurring in the first 24hours) including both "generic" surgical complications (especially postoperative bleeding) and complications more specific to lung surgery (Acute respiratory syndrome, atelectasis); (2) in-hospital complications and those occurring during the first 3 months; these are dominated by infectious events in particular pneumonia but also bronchial (bronchopleural fistula), pleural (pneumothorax, hydrothorax) or cardiac complications; (3) late complications are dominated by chronic pain, affecting 60% of patients having a thoracotomy at three months. Lobectomy is the most common lung resection. Pneumonectomy is a distinct procedure requiring a specific peri- and postoperative management. Right pneumonectomy is associated with a higher risk with a treatment related-mortality ranging between 7 and 10%. CONCLUSION Major lung resection has benefited from minimally invasive approaches and fast track to surgery. However, it is important to note the occurrence of new and specific complications related to those news surgical access.
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Boudoulas KD, Marmagkiolis K, Boudoulas H. Atrial Septal Defect Sizing and Transcatheter Closure. Cardiology 2019; 142:105-108. [PMID: 31117079 DOI: 10.1159/000496348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 12/04/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Konstantinos Dean Boudoulas
- Division of Cardiovascular Medicine, Department of Medicine, The Ohio State University, Columbus, Ohio, USA,
| | | | - Harisios Boudoulas
- Division of Cardiovascular Medicine, Department of Medicine, The Ohio State University, Columbus, Ohio, USA.,Biomedical Research Foundation, Academy of Athens, Athens, Greece
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Wintzer-Wehekind J, Alperi A, Houde C, Côté JM, Asmarats L, Côté M, Rodés-Cabau J. Long-Term Follow-Up After Closure of Patent Foramen Ovale in Patients With Cryptogenic Embolism. J Am Coll Cardiol 2019; 73:278-287. [DOI: 10.1016/j.jacc.2018.10.061] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/11/2018] [Accepted: 10/18/2018] [Indexed: 01/16/2023]
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Intracardiac Echocardiography in Structural Heart Disease Interventions. JACC Cardiovasc Interv 2018; 11:2133-2147. [DOI: 10.1016/j.jcin.2018.06.056] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 05/17/2018] [Accepted: 06/05/2018] [Indexed: 01/17/2023]
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Neill J, Lin CH. A Review of Transcatheter Closure of Patent Foramen Ovale. Methodist Debakey Cardiovasc J 2018; 13:152-159. [PMID: 29744000 DOI: 10.14797/mdcj-13-3-152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
A patent foramen ovale (PFO) is a common variant in cardiac anatomy found in 25% to 30% of U.S. adults. While PFOs are a normal part of fetal development and commonly seen in asymptomatic adults, they have been implicated in a variety of pathophysiologic conditions. The most clinically important of these is paradoxical embolization of venous thrombus resulting in stroke or systemic embolism. Various devices can be used to close PFOs via a transcatheter approach to prevent recurrent stroke. Data regarding the safety and effectiveness of these devices is rapidly evolving, with recent long-term results suggesting efficacy in preventing secondary stroke in carefully selected patients. This review discusses historical data on PFO occurrence and treatment, a risk score that can assess the likelihood of a stroke being attributable to a PFO, a variety of other conditions that may be linked to PFOs, and current research regarding the role transcatheter closure plays in their treatment.
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Affiliation(s)
- John Neill
- HOUSTON METHODIST DEBAKEY HEART & VASCULAR CENTER, HOUSTON METHODIST HOSPITAL, HOUSTON, TEXAS
| | - C Huie Lin
- HOUSTON METHODIST DEBAKEY HEART & VASCULAR CENTER, HOUSTON METHODIST HOSPITAL, HOUSTON, TEXAS
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Affiliation(s)
- Gianluca Rigatelli
- Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy
| | - Marco Zuin
- Section of Internal and Cardiopulmonary Medicine, Department of Medical Science, University of Ferrara, Ferrara, Italy
- Department of Cardiology, Rovigo General Hospital, Rovigo, Italy
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22
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Araszkiewicz A, Sławek S, Trojnarska O, Lesiak M, Grygier M. Interventional closure of patent foramen ovale with Nit-occlud® device in prevention of recurrent neurologic events-Long-term results. Catheter Cardiovasc Interv 2017; 92:159-164. [DOI: 10.1002/ccd.27386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 09/12/2017] [Accepted: 10/05/2017] [Indexed: 12/29/2022]
Affiliation(s)
| | - Sylwia Sławek
- Department of Cardiology; Poznan University of Medical Sciences; Poland
| | - Olga Trojnarska
- Department of Cardiology; Poznan University of Medical Sciences; Poland
| | - Maciej Lesiak
- Department of Cardiology; Poznan University of Medical Sciences; Poland
| | - Marek Grygier
- Department of Cardiology; Poznan University of Medical Sciences; Poland
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23
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Bechis MZ, Rubenson DS, Price MJ. Imaging Assessment of the Interatrial Septum for Transcatheter Atrial Septal Defect and Patent Foramen Ovale Closure. Interv Cardiol Clin 2017; 6:505-524. [PMID: 28886842 DOI: 10.1016/j.iccl.2017.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Transcatheter closure of atrial septal defects and patent foramen ovale has become increasingly common with advances in device and imaging technology. The percutaneous approach is now the preferred method of closure when anatomically suitable. Two-dimensional and 3-dimensional echocardiography determines anatomic suitability by characterizing the interatrial defect and its surrounding structures, and is critical for intraprocedural guidance and postprocedure follow-up. This article provides an overview of interatrial anatomy as it pertains to interventional considerations and discusses the transthoracic, transesophageal, and intracardiac echocardiographic modalities used for periprocedural and intraprocedural imaging of the interatrial septum.
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Affiliation(s)
- Mary Z Bechis
- Division of Cardiovascular Diseases, Scripps Clinic, 9898 Genesee Avenue, La Jolla, CA 92037, USA
| | - David S Rubenson
- Division of Cardiovascular Diseases, Scripps Clinic, 9898 Genesee Avenue, La Jolla, CA 92037, USA
| | - Matthew J Price
- Division of Cardiovascular Diseases, Scripps Clinic, 9898 Genesee Avenue, La Jolla, CA 92037, USA.
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24
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Nicolosi GL. Potential uselessness and futility of left atrial appendage occlusion and patent foramen ovale closure in cardioembolic stroke. J Cardiovasc Med (Hagerstown) 2017; 18:393-397. [DOI: 10.2459/jcm.0000000000000512] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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