Am J Cardiovasc Dis 2012;2(1):68-74
Original Article
Long-term results of the amplatzer cribriform occluder for patent foramen
ovale with associated atrial septal aneurysm: impact on occlusion rate and
left atrial functional remodelling
Gianluca Rigatelli, Fabio Dell’Avvocata, Paolo Cardaioli, Gabriele Braggion, Massimo Giordan, Alberto Mazza, Chiara
Fraccaro, Mauro Chinaglia, Jack P. Chen
Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo
General Hospital, Rovigo, Italy; Division of Internal medicine, Rovigo General Hospital, Rovigo, Italy; Neurosciences
department, Rovigo General Hospital, Rovigo, Italy; 4Saint Joseph’s Heart and Vascular Institute, Atlanta, GA, USA.
Received November 18, 2011; accepted November 29, 2011; Epub January 1, 2012; published January 15, 2012
Abstract: Background: Treatment of patients with concomitant patent foramen ovale (PFO) and atrial septal aneurysm
(ASA) poses a number of challenges; while some authors have suggested the off-label use of the Amplatzer Cribriform
Occluder in such anatomy, the long-term outcomes of this strategy is unknown. Our study aimed to assess the long-term
impact on closure rate, left atrial functional remodelling, and clinical outcomes of off-label implantation of Amplatzer ASD
Cribriform Occluder in patients with PFO and ASA. Methods We prospectively enrolled 160 consecutive patients with
previous stroke (mean age 36±9.5 years, 109 females), significant PFO and ASA. All patients were treated with Amplatzer
Cribriform Occluder to ensure the most complete possible coverage of the ASA. Residual shunt and LA passive and active
emptying, LA conduit function, and LA ejection fraction were computed before and after 6 months from the procedure and
then yearly. All patients underwent successful transcatheter closure (mean ratio device/diameter of interatrial septum =
0.74). Results. Incomplete ASA coverage during intraprocedural intracardiac echocardiography was observed in 71
patients. During mean follow-up of 3.6 ±1.8 years, when compared to patients with complete coverage, there were no
differences in LA functional parameters and complete occlusion achieved in 150/160 patients ( 93.7%). No new cerebral
ischemic events, aortic erosions or device thrombosis were recorded during the follow-up. Conclusions. The use of the
Amplatzer ASD Cribriform to treat PFO and associated ASA seems safe and effective: relatively small Occluder devices are
probably effective enough to promote left atrial functional remodelling. (AJCD1111003).
Keywords: Patent foramen ovale, stroke, embolism, cardiac anatomy, echocardiography
Full Text PDF
Address all correspondence to:
Gianluca Rigatelli, MD
Section of Adult Congenital Heart Disease
Cardiovascular Diagnosis and Endoluminal Interventions
Rovigo General Hospital, Rovigo, Italy.
Via WA Mozart, 9, 37040 Legnago, Verona - Italy
Phone: +3903471912016
Fax: +39044220164
E-mail: jackyheart@libero.it
Original Article
Long-term results of the amplatzer cribriform occluder for patent foramen
ovale with associated atrial septal aneurysm: impact on occlusion rate and
left atrial functional remodelling
Gianluca Rigatelli, Fabio Dell’Avvocata, Paolo Cardaioli, Gabriele Braggion, Massimo Giordan, Alberto Mazza, Chiara
Fraccaro, Mauro Chinaglia, Jack P. Chen
Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo
General Hospital, Rovigo, Italy; Division of Internal medicine, Rovigo General Hospital, Rovigo, Italy; Neurosciences
department, Rovigo General Hospital, Rovigo, Italy; 4Saint Joseph’s Heart and Vascular Institute, Atlanta, GA, USA.
Received November 18, 2011; accepted November 29, 2011; Epub January 1, 2012; published January 15, 2012
Abstract: Background: Treatment of patients with concomitant patent foramen ovale (PFO) and atrial septal aneurysm
(ASA) poses a number of challenges; while some authors have suggested the off-label use of the Amplatzer Cribriform
Occluder in such anatomy, the long-term outcomes of this strategy is unknown. Our study aimed to assess the long-term
impact on closure rate, left atrial functional remodelling, and clinical outcomes of off-label implantation of Amplatzer ASD
Cribriform Occluder in patients with PFO and ASA. Methods We prospectively enrolled 160 consecutive patients with
previous stroke (mean age 36±9.5 years, 109 females), significant PFO and ASA. All patients were treated with Amplatzer
Cribriform Occluder to ensure the most complete possible coverage of the ASA. Residual shunt and LA passive and active
emptying, LA conduit function, and LA ejection fraction were computed before and after 6 months from the procedure and
then yearly. All patients underwent successful transcatheter closure (mean ratio device/diameter of interatrial septum =
0.74). Results. Incomplete ASA coverage during intraprocedural intracardiac echocardiography was observed in 71
patients. During mean follow-up of 3.6 ±1.8 years, when compared to patients with complete coverage, there were no
differences in LA functional parameters and complete occlusion achieved in 150/160 patients ( 93.7%). No new cerebral
ischemic events, aortic erosions or device thrombosis were recorded during the follow-up. Conclusions. The use of the
Amplatzer ASD Cribriform to treat PFO and associated ASA seems safe and effective: relatively small Occluder devices are
probably effective enough to promote left atrial functional remodelling. (AJCD1111003).
Keywords: Patent foramen ovale, stroke, embolism, cardiac anatomy, echocardiography
Full Text PDF
Address all correspondence to:
Gianluca Rigatelli, MD
Section of Adult Congenital Heart Disease
Cardiovascular Diagnosis and Endoluminal Interventions
Rovigo General Hospital, Rovigo, Italy.
Via WA Mozart, 9, 37040 Legnago, Verona - Italy
Phone: +3903471912016
Fax: +39044220164
E-mail: jackyheart@libero.it
 |  |  |  |  |  |  |
| AJCD Copyright © 2011-present, All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711, USA |