Highlights
- •Antiplatelet therapy after the percutaneous closure of ASD/PFO effective.
- •ASA after percutaneous ASD/PFO closure was related to low rates of bleeding events.
- •ASA ensures a low incidence of device thrombosis and/or thrombotic events.
Abstract
Aims
The optimal antiplatelet therapy after atrial septal defect (ASD) or patent foramen
ovale device closure (PFO) remain to be established. We evaluated the safety and effectiveness
of 6-month 100 mg Aspirin (ASA) regimen in the very long-term follow up after intracardiac
echocardiography (ICE) –aided interatrial shunt closure in a large retrospective cohort.
Methods
Single-center retrospective analysis which included medical and instrumental data
of 789 consecutive patients referred to our institution over a 15 years period due
interatrial shunt catheter-based closure.
Results
Finally, 734 patients were included in the analysis (mean age 46.1 ± 14.6 years, 398
females): ASD and PFO closure were successfully performed in 281 and 453 patients,
respectively. Over the follow-up period, no major bleeding events were observed while
the rate of minor bleeding events was 0.9%. Tolerance problems were detected in 3.4%
of cases (n==28). In 11 patients (1.5%) an abnormal complete blood count was detected and monitored
up to normalization. On a mean follow –up of 10.3 ± 3.0 years (range 1–15), 10 patients
(1.36%) had a persistent moderate shunt 12 months after closure and maintained Aspirin
100 mg life-long, whereas the remaining 724 suspended the treatment after 6 months.
Device thrombosis in ASD and PFO groups were 0% and 0.2%, respectively. A cerebral
ischemic event occurred in 0.4% of the entire cohort.
Conclusions
A regimen of 100 mg of ASA for six months after ASD/PFO closure appeared to be both
safe and effective in preventing device thrombosis and major bleedings.
Keywords
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Article info
Publication history
Published online: January 02, 2020
Accepted:
December 17,
2019
Received in revised form:
November 28,
2019
Received:
October 22,
2019
Identification
Copyright
© 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Light anti-thrombotic regimen after interatrial shunt device closure: A strategy for all patients?European Journal of Internal MedicineVol. 74
- PreviewDuring the recent years, catheter-based closure of atrial septal defect (ASD) or patent foramen ovale (PFO) has become an effective and safe therapy for the curative treatment of patients with hemodynamically significant inter-atrial shunts [1]. Patients receiving this therapy present a peri-procedural risk of symptomatic thrombo-embolism of 1% to 2% [2] which raises to higher figures for asymptomatic episodes [3] and appears to be independent of the closure device used. In these patients, thrombus formation occurs more commonly in the setting of the procedure (through the delivery sheath or within the closure device).
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