Should we close hypoxaemic patent foramen ovale and interatrial shunts on a systematic basis?

Archives of Cardiovascular Diseases
Mohammad El TahlawiAlain Fraisse

Abstract

Rarely, hypoxaemia is associated with shunt reversal at the atrial level. Closure by interventional catheterization is the treatment of choice but indications and results have been studied insufficiently. To describe our experience with interventional closure of atrial right-to-left shunts described as hypoxaemic and the impact on patient oxygenation and clinical status. Retrospective study in two referral centres, including all patients undergoing closure of interatrial right-to-left shunt associated with hypoxaemia. Since 2001, 21 consecutive patients underwent interventional shunt closure using the "Amplatzer((R)) device"; two patients had atrial septal defect and 19 had patent foramen ovale. Three patients had minor adverse events; two patients have a tiny residual shunt. Transcutaneous oxygen saturation and partial oxygen pressure increased significantly from 86+/-5 to 95+/-3% (p<0.001) and from 49.8+/-6.8 to 82.9+/-30.4mmHg (p=0.001), respectively. Seventeen (80%) patients reported clinical improvement. However, patients with chronic respiratory insufficiency remained more symptomatic, with three deaths after a median follow-up of 35 (6-97) months and 89% remaining in New York Heart Association class III/IV (vs 29% of pat...Continue Reading

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Citations

Nov 22, 2011·Revue des maladies respiratoires·C BancalM Bonay
Jul 23, 2013·The American Journal of Cardiology·Brett E FensterJohn D Carroll
Aug 2, 2015·The International Journal of Cardiovascular Imaging·Brett E FensterJohn D Carroll
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Aug 2, 2017·Texas Heart Institute Journal·Michael E LayounJonathan M Tobis
Nov 11, 2017·Case Reports in Pulmonology·Hussain IbrahimSyed Gilani

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