During 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 [
- Pristipino C
- Sievert H
- D'Ascenzo F
- Mas JL
- Meier B
- Scacciatella P
- Scacciatella P
- Hildick-Smith D
- Gaita F
- Toni D
- Thomson J
- Derumeaux G
- Onorato E
- Sibbing D
- Germonprè P
- Berti S
- Chessa M
- Bedogni F
- Dudek D
- Hornung M
- Zamorano J
European position paper on the management of patients with patent foramen ovale. General
approach and left circulation thromboembolism.
Eur Heart J. 2019; 40: 3182-3195
[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). Nonetheless, clinical events due to cerebral
or peripheral embolism have been reported months and even years after the intervention
[
[4]
].To read this article in full you will need to make a payment
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References
- ESC guidelines for the management of grown-up congenital heart disease (new version 2010).Eur Heart J. 2010; 31: 2915-2957
- European position paper on the management of patients with patent foramen ovale. General approach and left circulation thromboembolism.Eur Heart J. 2019; 40: 3182-3195
- Thrombosis after septal closure device placement: a review of the current literature.Catheter Cardiovasc Interv. 2004; 63: 486-489
- Embolic stroke due to a left atrial thrombus two years after placement of an atrial septaldefect closure device.Am J Cardiol. 2017; 98: 1294-1296
- Interatrial shunts: technical approaches to percutaneous closure.Expert Rev Med Devices. 2018; 15: 707-716
- Transcatheter closure of atrial septal defect and patent foramen ovale in adult patients using the Amplatzer occlusion device: no evidence for thrombus deposition with antiplatelet agents.J Am Soc Echocardiogr. 2002; 15: 1094-1098
- Patent foramen oovale closure in 2019.Interv Cardiol. 2019; 14: 34-41
- Closure or medical therapy for cryptogenic stroke with patent foramen ovale.N Eng J Med. 2012; 366: 991-999
- Closure of patent foramen ovale versus medical therapy after cryptogenic stroke.N Eng J Med. 2013; 368: 1092-1100
- Percutaneous closure of patent foramen ovale in cryptogenic embolism.N Eng J Med. 2013; 368: 1083-1091
Rigatelli G, Zuin M, Dell'Avvocata F, Roncon L, Vassilev D, Nghia N. Light anti-thrombotic regimen for prevention of device thrombosis and/or thrombotic after interatrial shunts device-based closure. European J Int Med, In press (1,147).
Article info
Publication history
Published online: January 21, 2020
Accepted:
January 13,
2020
Received:
January 9,
2020
Identification
Copyright
© 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
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Access this article on ScienceDirectLinked Article
- Light anti-thrombotic regimen for prevention of device thrombosis and/or thrombotic complications after interatrial shunts device-based closureEuropean Journal of Internal MedicineVol. 74
- PreviewTranscatheter closure of both symptomatic atrial septal defect (ASD) and patent foramen ovale (PFO) has become a standard procedure in daily clinical practice, guaranteeing excellent technical results in terms of efficacy and safety. Although indications to closure are different between ASD and PFO, device type and shape are constructively very similar and in some case even identical between ASD and PFO populations [1]: as result, any proposed antiplatelet therapy was irrespective to the defect type and the two population can be analysed as a single one for pharmacologic purposes.
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