Patent foramen ovale closure in children without cardiopathy: Child-PFO study.
Accident vasculaire cérébral
Fermeture percutanée
Foramen ovale perméable
Patent foramen ovale
Percutaneous closure
Stroke
Journal
Archives of cardiovascular diseases
ISSN: 1875-2128
Titre abrégé: Arch Cardiovasc Dis
Pays: Netherlands
ID NLM: 101465655
Informations de publication
Date de publication:
Historique:
received:
09
07
2019
revised:
09
03
2020
accepted:
11
03
2020
pubmed:
19
7
2020
medline:
30
9
2020
entrez:
19
7
2020
Statut:
ppublish
Résumé
Closure of patent foramen ovale is well-managed in adults, but is performed less frequently in children. To analyse all patent foramen ovale closures performed in the past 20 years in French paediatric centres. Retrospective study of patent foramen ovale closures in children without cardiopathy in nine centres between 2000 and 2019. Forty-one procedures were carried out in children (median age: 14.9 years). Thirty-one patent foramen ovales were closed after a transient ischaemic attack or stroke, six for a left-to-right shunt and four for other reasons. Transthoracic echocardiography was used for 72.2% of the diagnoses and transoesophageal echocardiography for 27.8%. A substantial degree of shunting was found in 42.9% of patients and an atrial septal aneurysm in 56.2%. General anaesthesia with transoesophageal echocardiography guidance was performed in 68.3% of the procedures; local anaesthesia and transthoracic echocardiography or intracardiac echocardiography was performed in 31.7%. The success rate was 100%. The median fluoroscopy time was 4.14minutes: 3.55minutes with transoesophageal echocardiography; and 4.38minutes with transthoracic echocardiography (P=0.67). There was only one periprocedural complication (2.4%). Postoperatively, 80,5% of patients were treated with aspirin and 12,2% with an anticoagulant. The rate of complete occlusion was 56.8% immediately after the procedure, 68.6% at 1 year and 92.3% at the last follow-up. There were no delayed complications or cases of recurrent stroke during follow-up (median follow-up: 568 days). Closure of patent foramen ovale in children appears to be safe and effective, as we noted a low rate of immediate complications, no delayed complications and no stroke recurrence in this indication.
Sections du résumé
BACKGROUND
BACKGROUND
Closure of patent foramen ovale is well-managed in adults, but is performed less frequently in children.
AIM
OBJECTIVE
To analyse all patent foramen ovale closures performed in the past 20 years in French paediatric centres.
METHODS
METHODS
Retrospective study of patent foramen ovale closures in children without cardiopathy in nine centres between 2000 and 2019.
RESULTS
RESULTS
Forty-one procedures were carried out in children (median age: 14.9 years). Thirty-one patent foramen ovales were closed after a transient ischaemic attack or stroke, six for a left-to-right shunt and four for other reasons. Transthoracic echocardiography was used for 72.2% of the diagnoses and transoesophageal echocardiography for 27.8%. A substantial degree of shunting was found in 42.9% of patients and an atrial septal aneurysm in 56.2%. General anaesthesia with transoesophageal echocardiography guidance was performed in 68.3% of the procedures; local anaesthesia and transthoracic echocardiography or intracardiac echocardiography was performed in 31.7%. The success rate was 100%. The median fluoroscopy time was 4.14minutes: 3.55minutes with transoesophageal echocardiography; and 4.38minutes with transthoracic echocardiography (P=0.67). There was only one periprocedural complication (2.4%). Postoperatively, 80,5% of patients were treated with aspirin and 12,2% with an anticoagulant. The rate of complete occlusion was 56.8% immediately after the procedure, 68.6% at 1 year and 92.3% at the last follow-up. There were no delayed complications or cases of recurrent stroke during follow-up (median follow-up: 568 days).
CONCLUSION
CONCLUSIONS
Closure of patent foramen ovale in children appears to be safe and effective, as we noted a low rate of immediate complications, no delayed complications and no stroke recurrence in this indication.
Identifiants
pubmed: 32680737
pii: S1875-2136(20)30141-8
doi: 10.1016/j.acvd.2020.03.021
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
513-524Informations de copyright
Copyright © 2020 Elsevier Masson SAS. All rights reserved.