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Safety and efficacy of endovascular patent foramen ovale closure: the first results of a Russian multicenter study

https://doi.org/10.14412/2074-2711-2020-6-26-32

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Abstract

Patent foramen ovale (PFO) is detectable in more than 25% of the adult population and is generally clinically insignificant. However, it can be a cause of paradoxical embolism in some cases. Randomized trials indicate that endovascular PFO closure in patients with a history of cryptogenic stroke is an effective method for the secondary prevention of catastrophic brain damage.

Objective: to study the safety and efficiency of endovascular PFO closure in young patients with a history of cryptogenic stroke.

Patients and methods. Sixty-two patients, including (22 males and 40 females) women, underwent percutaneous PFO closure in May 2018 to March 2020. The patients' mean age was 37.4±7.6 years. The inclusion criteria were a prior cryptogenic ischemic stroke lasting less than 12 months and PFO with a high risk for paradoxical embolism (PFO concurrent with atrial septal aneurysm or hypermobility; PFO, ≥2 mm size; the presence of the Chiari network and/or the Eustachian valve).

Results and discussion. The technical success of the operation was achieved in all cases. In 50 (80.6%) patients, the right chamber of the heart was completely isolated from the left one in the first 3 months. During the first year, the atria were also completely isolated in 10 (16.1%) patients. A left-to-right shunt persisted in 2 (3.2%) patents 12 months later. Two patients were found to have main procedural complications: one had perioperative atrial fibrillation and the other had pseudoaneurysm formation at the puncture site.

Conclusion. Endovascular PFO closure is a safe and effective operation for the secondary prevention of recurrent ischemic stroke. In our study, blood shunting through the PFO was stopped in 96.6% of patients at less than 6 months after surgery, which suggests that there is a rapid and effective reduction in the risk of paradoxical embolism.

About the Authors

D. V. Ognerubov
National Medical Research Center of Cardiology, Ministry of Health of Russia
Russian Federation

Dmitry Viktorovich Ognerubov

15a, Third Cherepkovskaya St., Moscow 121552

 



A. S. Tereshchenko
National Medical Research Center of Cardiology, Ministry of Health of Russia
Russian Federation

15a, Third Cherepkovskaya St., Moscow 121552



A. N. Samko
National Medical Research Center of Cardiology, Ministry of Health of Russia
Russian Federation

15a, Third Cherepkovskaya St., Moscow 121552



G. К. Arutyunyan
National Medical Research Center of Cardiology, Ministry of Health of Russia
Russian Federation

15a, Third Cherepkovskaya St., Moscow 121552



O. A. Sivakova
National Medical Research Center of Cardiology, Ministry of Health of Russia
Russian Federation

15a, Third Cherepkovskaya St., Moscow 121552



D. V. Pevzner
National Medical Research Center of Cardiology, Ministry of Health of Russia
Russian Federation

15a, Third Cherepkovskaya St., Moscow 121552



M. I. Makeev
National Medical Research Center of Cardiology, Ministry of Health of Russia
Russian Federation

15a, Third Cherepkovskaya St., Moscow 121552



T. V. Balakhonova
National Medical Research Center of Cardiology, Ministry of Health of Russia
Russian Federation

15a, Third Cherepkovskaya St., Moscow 121552



A. V. Belopasova
Research Center of Neurology
Russian Federation

80, Volokolamskoe Shosse, Moscow 125367



M. Yu. Maksimova
Research Center of Neurology
Russian Federation

80, Volokolamskoe Shosse, Moscow 125367



S. E. Chuprina
Voronezh Regional Clinical Hospital One
Russian Federation

151, Moskovsky Prospect, Voronezh 394066



E. P. Khodyakova
Voronezh Regional Clinical Hospital One
Russian Federation

151, Moskovsky Prospect, Voronezh 394066



A. A. Kulesh
Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia
Russian Federation

26, Petropavlovskaya St., Perm 614990



S. A. Mekhryakov
City Clinical Hospital Four
Russian Federation

2, KIM St., Perm 614107



D. Yu. Shchekochikhin
N.I. Pirogov City Clinical Hospital, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

8, Leninsky Prospect, Moscow 119049,

8, Trubetskaya St., Build. 2, Moscow 119991



A. A. Bogdanova
N.I. Pirogov City Clinical Hospital, Moscow Healthcare Department; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation

8, Leninsky Prospect, Moscow 119049,

1, Ostrovityanov St., Moscow 117997



E. V. Merkulov
National Medical Research Center of Cardiology, Ministry of Health of Russia
Russian Federation

15a, Third Cherepkovskaya St., Moscow 121552



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For citation:


Ognerubov D.V., Tereshchenko A.S., Samko A.N., Arutyunyan G.К., Sivakova O.A., Pevzner D.V., Makeev M.I., Balakhonova T.V., Belopasova A.V., Maksimova M.Yu., Chuprina S.E., Khodyakova E.P., Kulesh A.A., Mekhryakov S.A., Shchekochikhin D.Yu., Bogdanova A.A., Merkulov E.V. Safety and efficacy of endovascular patent foramen ovale closure: the first results of a Russian multicenter study. Neurology, Neuropsychiatry, Psychosomatics. 2020;12(6):26-32. (In Russ.) https://doi.org/10.14412/2074-2711-2020-6-26-32

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)