Percutaneous patent foramen ovale closure during live case demonstrations.
Adult
Aged
Cardiac Catheterization
/ adverse effects
Ductus Arteriosus, Patent
/ diagnostic imaging
Education, Medical
Female
Humans
Male
Middle Aged
Patient Safety
Radiography, Interventional
Randomized Controlled Trials as Topic
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Video Recording
PFO closure
cryptogenic stroke
live case
patent foramen ovale
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139
Informations de publication
Date de publication:
01 04 2019
01 04 2019
Historique:
received:
26
01
2018
revised:
24
10
2018
accepted:
14
11
2018
pubmed:
15
12
2018
medline:
19
5
2020
entrez:
15
12
2018
Statut:
ppublish
Résumé
Live case demonstrations serve as an educational tool for interventional techniques in cardiology. The aim of this study was to assess the safety and technical success of percutaneous patent foramen ovale (PFO) closure during live case demonstrations. All patients who had undergone percutaneous PFO closure with Amplatzer devices during live case demonstrations at our institution were consecutively included in this retrospective analysis. Procedure related events were compared with summary event rates derived from the eight randomized controlled trials (RCTs) investigating PFO closure, as well as with a propensity matched cohort of patients treated under usual conditions. From April 2004 to June 2015, 142 patients underwent percutaneous PFO closure during live demonstrations, mainly for secondary prevention of cryptogenic cerebrovascular events. The interventions were fluoroscopy guided and successful in all but three cases (2%). Minor adverse events occurred in nine patients (6%). Contrast TEE performed at about 6 months showed complete closure in 84%. No significant differences with regard to technical success and major complications rate were found compared to RCTs, except for an increased rate of minor bleeding observed during live case demonstrations (P for difference < 0.001), mainly attributable to concomitant arterial access for incidental coronary angiography performed in 70% of patients. Except for slightly longer procedure duration, no difference was found compared to a matched population treated under usual conditions. Percutaneous PFO closure can be performed during live case demonstrations with the same high technical success as during routine cases.
Sections du résumé
BACKGROUND
Live case demonstrations serve as an educational tool for interventional techniques in cardiology. The aim of this study was to assess the safety and technical success of percutaneous patent foramen ovale (PFO) closure during live case demonstrations.
METHODS
All patients who had undergone percutaneous PFO closure with Amplatzer devices during live case demonstrations at our institution were consecutively included in this retrospective analysis. Procedure related events were compared with summary event rates derived from the eight randomized controlled trials (RCTs) investigating PFO closure, as well as with a propensity matched cohort of patients treated under usual conditions.
RESULTS
From April 2004 to June 2015, 142 patients underwent percutaneous PFO closure during live demonstrations, mainly for secondary prevention of cryptogenic cerebrovascular events. The interventions were fluoroscopy guided and successful in all but three cases (2%). Minor adverse events occurred in nine patients (6%). Contrast TEE performed at about 6 months showed complete closure in 84%. No significant differences with regard to technical success and major complications rate were found compared to RCTs, except for an increased rate of minor bleeding observed during live case demonstrations (P for difference < 0.001), mainly attributable to concomitant arterial access for incidental coronary angiography performed in 70% of patients. Except for slightly longer procedure duration, no difference was found compared to a matched population treated under usual conditions.
CONCLUSION
Percutaneous PFO closure can be performed during live case demonstrations with the same high technical success as during routine cases.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
982-988Informations de copyright
© 2018 Wiley Periodicals, Inc.