Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Achim, A; Hochegger, P; Kanoun, Schnur, SS; Moser, L; Stark, C; Pranevičius, R; Prunea, D; Schmidt, A; Ablasser, K; Verheyen, N; Kolesnik, E; Maier, R; Luha, O; Ruzsa, Z; Zirlik, A; Toth, GG.
Transesophageal echocardiography-guided versus fluoroscopy-guided patent foramen ovale closure: A single center registry.
ECHOCARDIOGR-J CARD. 2023; 40(7): 657-663.
Doi: 10.1111/echo.15630
Web of Science
PubMed
FullText
FullText_MUG
- Führende Autor*innen der Med Uni Graz
- Toth-Gayor Gabor
- Co-Autor*innen der Med Uni Graz
- Ablasser Klemens
- Kanoun Schnur Sadeek Sidney
- Kolesnik Ewald
- Maier Robert
- Moser Lisa
- Pranevicius Robertas
- Prunea Dan-Mihai
- Schmidt Albrecht
- Verheyen Nicolas Dominik
- Zirlik Andreas
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- BACKGROUND: Percutaneous closure of patent foramen ovale (PFO) is conventionally performed under continuous transesophageal echocardiographic (TEE) guidance. We aimed to evaluate whether a simplified procedural approach, including pure fluoroscopy-guidance and final TEE control, as well as an aimed 'next-day-discharge' is comparable with the conventional TEE-guided procedure in terms of periprocedural and intermediate-term outcomes. METHODS: All patients who underwent a PFO closure at our center between 2010 and 2022 were retrospectively included. Prior to June 2019 cases were performed with continuous TEE guidance (TEE-guided group). Since June 2019, only pure fluoroscopy-guided PFO closures have been performed with TEE insertion and control just prior to device release (fluoroscopy-guided group). We analyzed procedural aspects, as well as long term clinical and echocardiographic outcomes. RESULTS: In total 291 patients were included in the analysis: 197 in the TEE-guided group and 94 in the fluoroscopy-guided group. Fluoroscopy-guided procedures were markedly shorter (48 ± 20 min vs. 25 ± 9 min; p < .01). There was no difference in procedural complications, including death, major bleeding, device dislodgement, stroke or clinically relevant peripheral embolization between the two groups (.5% vs. 0%; p = .99). Hospital stay was also shorter with the simplified approach (2.5 ± 1.6 vs. 3.5 ± 1.2 days; p < .01), allowing 85% same-day discharges during the last 12 months of observation period. At 6 ± 3 months echocardiographic follow-up a residual leakage was described in 8% of the TEE-guided cases and 2% of the fluoroscopy-guided cases (p = .08). CONCLUSION: While a complete TEE-free PFO closure might have potential procedural risks, our approach of pure fluoroscopy-guided with a brisk final TEE check seems to be advantageous in terms of procedural aspects with no sign of any acute or intermediate-term hazard and it could offer an equitable compromise between the two worlds: a complete TEE procedure and a procedure without any TEE.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Echocardiography, Transesophageal - methods
- Foramen Ovale, Patent - diagnostic imaging, surgery
- Retrospective Studies - administration & dosage
- Treatment Outcome - administration & dosage
- Septal Occluder Device - administration & dosage
- Fluoroscopy - methods
- Cardiac Catheterization - methods
- Registries - administration & dosage
- Find related publications in this database (Keywords)
- patent foramen ovale
- percutaneous closure
- transesophageal echocardiography